As part of its annual budget deliberations, the Indian River County Hospital District voted unanimously last week to set aside $2 million in the coming year’s budget that could be used to subsidize maternity care at Vero Beach’s only hospital.

For Cleveland Clinic to get that money, however, the Hospital District still needs to approve a yet-to-be developed sustainability plan which ensures that Vero’s Labor and Delivery Unit will remain open for the long term.

In August, after hospital officials voiced concern about $3.5 million annual labor and delivery operating losses, the issue mushroomed into a panic that Cleveland Clinic might be planning to soon shutter the unit.

Hospital officials had not threatened to end maternity services locally, but had notified the district it was continuing to see a volume of babies that was 300 to 400 fewer than the maternity unit was designed and staffed to handle, resulting in ongoing financial losses.

The Hospital District subsequently floated surveys and got live input from the community at three town hall meetings, resulting in overwhelming support for keeping Cleveland Clinic’s Labor and Delivery Unit operating for the foreseeable future.

Earlier this month, Dr. Richard Rothman, Cleveland Clinic Indian River Hospital vice president and chief medical officer, Richard submitted a funding request to the Hospital District seeking  $2 million in fiscal 2025-2026, or roughly 57 percent of one year’s anticipated maternity losses.

“Labor and Delivery focuses on providing hospital based maternity services to all women in Indian River County regardless of their financial ability to pay for services, which will result in healthy women and children in our community,” Rothman said in the request.

While the trustees voted to include $2 million in taxpayer funds for Cleveland Clinic in its budget, Hospital District director Frank Isele emphasized that “there would be no funds released until the district trustees and the hospital have a fully executed 12-month maternity service agreement, which is a one-time thing, and would provide the public with a plan for delivery, performance expectations, and accountability standards to ensure progress towards a sustainable future for maternity care in our county.”

The 75-year lease agreement the Hospital District struck with Cleveland Clinic in 2018 which paved the way for the takeover of Vero’s hospital in 2019 gave Cleveland Clinic two potential loopholes to close its maternity unit here.

The first is a limited 10-year commitment by Cleveland Clinic to provide certain services here.  This commitment runs through 2029.

The second is a clause saying that if a service is provided within 25 miles or less from the Vero hospital, that service can be terminated before 2029. 

District trustees and legal counsel will likely want to see some closure of those loopholes in exchange for further commitment of taxpayer dollars to Cleveland Clinic for maternity services.

Hospital District trustees said they want to not only maintain current maternity services here, but also see a Level Two Neonatal Intensive Care Unit established in Vero. Rothman said he is open to this, but that a Level Two NICU would cost an additional $1.5 million to $2 million per year. Cleveland Clinic’s pediatric partner Nemours Children’s hospital leadership confirmed it is eager to provide NICU staffing in Vero.

Rothman touted the high level of care provided in Vero and “maternal and infant outcomes that are better than the state and national average” plus above-average patient satisfaction scores.

The Cleveland Clinic hospital foundation also hopes to raise up to $1 million in unrestricted gifts over the next year which could be used for Labor and Delivery.  In December, Cleveland Clinic plans to debut its $7 million remodeled maternity unit to the public. Those improvements were funded through local philanthropy.