Hospital District — Indian River County, Florida

The Indian River County Hospital District is an independent special taxing district, run by seven elected trustees from an office on 19th Place in Vero Beach, that owns Cleveland Clinic Indian River Hospital and funds care for uninsured residents countywide.

A special act of the 1959 Florida Legislature created the district and a Board of Trustees with seven publicly elected members, which took control of the hospital (IRCHD history page). The district's audit adds that the act was re-established in 1961 and amended and restated in 2003 as Florida House Bill No. 1601, and that it authorizes the trustees to support health facilities for the entire population of Indian River County, particularly residents medically certified as indigent (IRCHD FY 2024-25 audit, page 6).

The district still owns the hospital but does not run it. The audit describes the district as the owner of Cleveland Clinic Indian River Hospital in Vero Beach, licensed for 335 beds, leased since January 1, 2019, with about 45 acres of undeveloped land, to Indian River Memorial Hospital, Inc., an affiliated not-for-profit established and owned by Cleveland Clinic Florida Regional Health System Nonprofit Corporation; the lease runs to December 31, 2049 and renews automatically for three fifteen-year periods unless the hospital delivers a written non-renewal notice (IRCHD audit, note 1). That arrangement goes back to 1984, when the trustees relinquished management of the hospital, leased it to Indian River Memorial Hospital, Inc. and created an Indigent Care Agreement to assist with funding for uninsured residents (IRCHD history page).

Funding reached the north county early. The district began paying for the Fellsmere Medical Center in 1994, the clinic that became Treasure Coast Community Health, and in 1996 leased a portion of a former Gifford school to establish a health center (IRCHD history timeline). The district office is at 1705 19th Place, Suite G3, Vero Beach, phone 772-770-0935 (IRCHD Trustees page).

For fiscal 2026-27 the district levies 0.7121 mills on taxable property across Indian River County, including Sebastian, Fellsmere and Vero Beach, the same as its rolled-back rate.

The final approved budget sets the millage at 0.7121, equal to a rolled-back rate of 0.7121, so the rate stands at 0.00% above rollback; the prior levy was 0.7450 (IRCHD FY 2026-27 budget, page 4). A mill is the tax per thousand dollars of taxable value, and the Indian River County Tax Collector levies and collects the district's taxes (IRCHD audit, note 1(f)). For a Sebastian home with $250,000 of taxable value, the 2026-27 district line works out to $178.03 (250 times 0.7121).

The earlier rates come from the district's audit as filed with the Florida Auditor General, which lists 0.7144 for 2021/2022 and 0.5110 for 2022/2023 and 2023/2024 (Florida Auditor General filing). The FY 2024-25 audit gives 0.7650 for 2024/2025, 0.7450 for 2025/2026, and puts the district at 5.43% of the 14.0812 total mills assessed in Indian River County that year (IRCHD audit, Table 1).

A lower rate still brings in more money because values grew. Gross taxable value in the district rose to $33,922,017,834 from a prior-year $31,768,785,569, and the 0.7121 rate raises $24,155,869 against prior-year proceeds of $23,667,745, an increase of $488,124 by subtraction, on a total budget $620,502 or 2.31% smaller than the year before (FY 2026-27 budget, page 4). Sebastian and Fellsmere owners pay the same district rate as owners in Vero Beach or the unincorporated county.

The district's largest budget category is program and service expenses: $22,814,563 in the 2026-27 budget, led by Cleveland Clinic Indian River Hospital and Treasure Coast Community Health in Vero Beach and Fellsmere.

The hospital and community health center figures are on pages 1 and 2 of the final budget (IRCHD budget, page 1; page 2), the VNA hospice line on page 2, and the Whole Family Health Center and remaining VNA lines on page 3, which also lists $303,193 in commissions to the Property Appraiser and $490,275 to the Tax Collector (IRCHD budget, page 3). Smaller lines include $603,388 for the Senior Resource Association on page 2, most of it Meals on Wheels. Page 1 carries a reserve fund of $11,025,787.

The audited year shows the same pattern. For the year ended September 30, 2025, net ad valorem revenue was $21,181,197 and indigent care and program funding was $18,844,188 (IRCHD audit, Table 4). That funding rose $2,802,044, or 17.5%, and the audit lists among the reasons a July 2025 commitment of $1 million over four years to expand Treasure Coast Community Health's Oslo Pediatric Center and West Primary Care services in Vero Beach (IRCHD audit, financial highlights). Net position stood at $12,191,530 at September 30, 2025.

Indian River County residents with no health insurance and household income at or below 200% of the Federal Poverty Level can get no-cost primary care through Treasure Coast Community Health or Whole Family Health Center in Vero Beach.

The district's Financial Assistance Program lists three conditions: current residence in Indian River County, income at or below 200% of the Federal Poverty Level, and no health insurance (IRCHD Financial Assistance Program). Applicants call Treasure Coast Community Health at (772) 257-8224 and ask for a Health Navigator, or Whole Family Health Center at (772) 345-9342 and ask for an Intake Specialist, then bring an application form, photo ID, proof of income for the last 4 weeks and two proofs of residency dated within the last 9 months.

The program reaches past primary care. The same page lists dental care and OB/GYN services at Treasure Coast Community Health, behavioral health at the Mental Health Association on 37th Place and New Horizons on 82nd Avenue, and home health and hospice through the VNA of the Treasure Coast on 20th Place, all in Vero Beach, at no or reduced cost.

For north county residents, the location list matters. The district page describes Treasure Coast Community Health primary care as available at multiple locations in Vero Beach, Sebastian and Fellsmere, but the clinic's own locations page, read October 12, 2026, lists no Sebastian center: its north county site is the Fellsmere center at 12196 CR 512, and the rest are in Vero Beach and Gifford (Treasure Coast Community Health, Locations). A Sebastian or Roseland applicant can start with the Fellsmere center or the central phone line.

Six of the seven elected trustee seats were filled on October 12, 2026, with Kerry Bartlett of Vero Beach as chairman and Seat 7 listed as vacant on the district's Trustees page.

Each trustee is an elected official serving a four-year staggered term; four are elected at one general election and three at the next, and when a seat falls vacant the Governor of Florida appoints someone to finish the term (IRCHD Trustees).

The board's regular monthly meetings for the rest of 2026 are set for October 15, November 19 and December 17, each at 4 p.m., and the fiscal 2026-27 budget hearings were held on September 3 and September 8 at 5:01 p.m. (IRCHD Meeting Schedule). Agendas, minutes and financial documents are listed in the district website menu at irchd.com. Last verified: October 12, 2026, against the hospital district's Trustees, Financial Assistance Program and Meeting Schedule pages, its FY 2026-27 final budget and its FY 2024-25 audit.