Six local nonprofit programs will be weaned off taxpayer funding over the next three years as the Indian River County Hospital District – which in recent times has taken an increasingly expansive view of its grant-making authority – seeks to bring its spending into closer alignment with the legislation that created it.

The Hospital District was established by a special act of the Florida Legislature in 1959 that authorized it to levy property taxes to fund health and medical services provided by or under the supervision of a licensed healthcare professional.

But in recent years, since Cleveland Clinic took over the Indian River Hospital and lifted a $7 million annual indigent care burden from taxpayers, Hospital District trustees have been expanding taxpayer support to ancillary nonprofit services.

Now, with state government efficiency efforts taking a tougher look at how tax dollars are being used, Hospital District trustees decided to apply stricter standards to requests by nonprofits for funding, trimming nearly $2 million from requests not precisely aligned with the district’s medical and healthcare mandate.

With slight variations, the Hospital District plans to fund the six targeted programs at 50 percent to 75 percent of the amount requested in the 2025-26 fiscal year which began Wednesday (Oct. 1), then reduce funding further in 2026-27 and 2027-28. Most of the programs had requested significantly more funding for 2026 than they’d received in 2025.

The nonprofits that manage the six programs that are being severely cut back are the Senior Resource Association, the Visiting Nurse Association, Tykes and Teens and the Learning Alliance.

The Senior Resource Association – whose executive director, Karen Deigl, also serves on the Hospital District board of trustees – was the hardest hit by the sunset plan.

During Deigl’s tenure on the Hospital District board, its funding of the SRA had expanded considerably.   Deigl was narrowly re-elected in 2024 to another four years on the board, but three of the SRA programs – the Meals on Wheels program, the Public Guardian Program for seniors, and the Emergency Alert Response System – were scrutinized more closely this year.

The SRA staff pleaded with trustees during the budget sessions, asserting that delivering nutritional meals to vulnerable seniors is a healthcare service, and that not only do the meals prevent illness in recipients of Meals on Wheels, but that the human contact provided by SRA volunteers improves the mental health and well-being of clients.

“MOW is much more than a meal. Real human connection keeps our homebound elderly neighbors whole. Our latest survey results indicate more than one quarter of those served by home delivery only see or speak with someone other than our MOW drivers three times a week. That’s why the warm hello and wellness checks that accompany our home-delivered meals represent a vital lifeline that keeps vulnerable seniors healthy and out of harm’s way,” the SRA request to the district said.

Nevertheless, Hospital District funds that help support this program will be cut by a quarter-million dollars in the coming year.

The Emergency Alert Response System is a spinoff of Meals on Wheels. Over the years, meal delivery drivers noted that many seniors with a high risk of falls and injuries at home lacked the means to pay for a private 24/7 in-home or wearable monitoring system.

“SRA’s Emergency Alert Response Systems are designed to provide an in-home lifeline at no charge to at-risk older adults in our community,” the SRA told trustees. “Our program enables seniors to maintain their independence and peace of mind, and in keeping with our mission, allows at-risk IRC residents to continue living in their own homes as long as safely possible.”

Hospital District funds for this program were cut by $65,000.

The agency’s Public Guardian Program enlists volunteers and local attorneys to advocate on behalf of indigent seniors.

“Our trained guardians have responsibility for those who have been deemed incapacitated by the 19th Judicial Circuit and assigned to SRA for care. These individuals lack adequate income or assets to afford a private guardian and have no willing, able family member or friend to serve in that capacity. These vulnerable adults of limited cognitive and financial means face great risk of abuse, neglect, and/or exploitation,” the SRA told trustees.

The Hospital District cut the $150,000 requested for this program by half.

The Visiting Nurse Association also had a program in its funding request – Community Music Therapy – that trustees felt did not meet the requirements for full funding.

The VNA argued that music therapy can be medically significant, especially for dementia or mental health, though the care is not delivered by a doctor or nurse.

“Our music therapists design and implement interventions to meet clinical goals. These interventions are evidence-based and aim to complement existing treatments, providing a holistic approach to mental health care,” VNA told the trustees.

VNA was hoping to expand music therapy, but the Hospital District cut program funding by $10,000. Eventually VNA will need sponsors to contribute $86,000 once underwritten by taxpayers.

Two programs on the sunset track seem very similar to each other, and serve children with preventative behavioral health support services in preschools, and early childhood mental health consultations.

The two programs had been receiving nearly a half-million dollars from the Hospital District. In the coming year Tykes and Teens will get $199,000 and the Learning Alliance will get $82,500 in taxpayer funding.

The Learning Alliance support service for preschoolers goes into classrooms and trains early childhood educators to recognize potential behavioral health issues. “Unlike ‘clinical therapy,’ which is not appropriate for the classroom setting, this program supports the student, the teacher, the classroom, and the family to foster student success,” the Learning Alliance told the district trustees.

Tykes and Teens Early Childhood Mental Health Consultation program explained its purpose in its funding request, saying, “By embedding a mental health consultant in Indian River childcare centers, we ensure that teachers receive the tools and guidance needed to foster emotionally supportive classrooms, ultimately benefiting young children.”

Hospital District Executive Director Frank Isele and the staff said the organizations with sunsetting grants were encouraged to re-design the programs or collaborate with other agencies to conform more closely aligned with the district’s health and medical care goals, and reapply in the future.