Hospital District now expects USDA decision in October


PINEDALE – Federal loan applications for multi-million-dollar projects involve thousands of pages of documentation and require many staff hours to compile, said Tonia Hoffman, the Sublette County Hospital District Board of Trustees Chairwoman on Sept. 15.

The complexity of the process can result in delays.

The hospital district initially expected a decision from the U.S. Department of Agriculture on a loan to fund a new critical access hospital at the end of August but now have to wait until October.

Kari DeWitt, public relations director, explained to the Examiner the wait was “100 percent” due to the federal fiscal year ending on Sept. 30. Grant applications submitted to the USDA require a final hearing at the national level. The agency spends September completing end-of-year reports and does not hold hearings again until the start of the next fiscal year in October, DeWitt added.

Once the loan application gets to the national level, hearings before the USDA board typically take only a half-hour, Doorn told the trustees. The need for an airtight application to present to the federal board in a short time period is crucial, he added.

Lorraine Werner, the USDA community programs director in Wyoming, is working to guarantee all the district’s ducks are in a row for an October hearing, Doorn said.

“Lorraine Werner is really doing what she does best – fully understanding our application and leaving no stone unturned and is completely prepared to present it at a national level,” Doorn said in a press release.

Werner supported the hospital district’s proposal, though she is not able to officially endorse the application at this time, Doorn stated to trustees on Sept. 15.

The hospital district’s application will be one of the first on the docket in October, Doorn explained to the board. The delay reflected “nothing negative” in the hospital district’s application, he said.

Werner and her staff remained in constant communication with the hospital district and management team at Star Valley Health, Doorn and Hoffman said.

Layton Construction Company, the district’s construction manager, is prepared to move forward with a pre-bid meeting with subcontractors to begin construction, DeWitt stated in the press release.

The district scheduled a meeting with Werner this week to discuss early work releases to begin some of the dirt work before the application is approved, DeWitt told the Examiner.

Trustee Jamison Ziegler encouraged the board to meet with Layton and discuss the construction timetable. Building is not expected to begin until March when steel becomes available on the market, Ziegler said.

The district needed to have a conversation with Layton to compare costs on starting early work before the arrival of steel or pushing the entire project off to March, Ziegler said.

Staffing shortages

Trustees and hospital district staff addressed staff shortages, including the loss of several nurses, during last week’s meeting.

Hoffman said the board was working to “do the best we can” to remedy the situation. The trustees “understand staff concerns” and asked the public for patience.

Doorn reported the district already hired one nurse and was aggressively advertising to fill additional positions. The district was also in the process of interviewing physicians, he added.

The nursing shortage reflected a nationwide crisis in staffing and was not a local issue, Doorn said. The district was competing in an unfavorable labor market where large health-care companies are able to entice nurses with much higher wages, Doorn added.

The district hoped to receive money from the American Rescue Plan Act (ARPA) of 2021 to offer providers and staff working at both clinics a significant retention bonus, DeWitt said. Gov. Mark Gordon committed $30 million in ARPA funds dedicated to retaining hospital and clinical providers in Wyoming – $20 million for hospitals and $10 million for other facilities like the hospital district, DeWitt added.

Benefits, particularly health insurance, played a role in keeping employees in Sublette County, said Sharon Rutsch, clinical services coordinator and laboratory manager, during the meeting.

Trustee Dave Bell, a member of the finance committee, stated he and Doorn met to discuss purchasing 2022 health insurance plans for employees. Bell encouraged the board to put health insurance out to bid, look at the market and seek out “various alternatives and approaches” to find the best plans.

Due to concern over conflict of interest, Bell stressed that he no longer holds a license to sell insurance.

Doorn and Bell said the goal was to meet or exceed plans presently held by employees.

Bell stated the combined staff from the Sublette Center and hospital district would provide a larger employee pool and potentially open up more options in the insurance market.

An exceptional month

Trustee Kenda Tanner, a finance committee member, reported that the clinics had an “amazing month” in August 2021 compared to August 2020. Profit was up significantly, and Tanner called August 2021 “the best month to date” financially.

The clinic made a net profit of $210,317 in August not including capital expenditure, the public financial report indicated.

Bell highlighted major increases in services at both clinics, from radiology and EMS to the laboratory.

Scheduled appointments at the Big Piney and Marbleton Clinic were up 23 percent compared to the previous year with same-day visits up 13 percent. Scheduled appointments at the Pinedale Clinic dropped slightly, but were offset by a 49-percent rise in same-day visits.

Nursing visits increased 93 percent at the Pinedale Clinic and 260 percent at Big Piney-Marbleton.

Bell said he and the board were “proud of the staff” for their exceptional efforts during a busy month.

Additional board news

  • Trustees approved the transfer of $750,000 from reserves to fund hospital district operations. Tanner explained the district would not receive expected tax revenue of $2.4 million until November. Doorn added that the district was also waiting on the USDA loan money to reimburse project-related expenses like architectural fees.
  • The board signed a lease agreement with Allen Insurance to provide temporary space for Public Health. The two-month lease begins in October. Hoffman stated once the district received approval from the USDA on its loan or early release work could begin, Public Health had a place “ready to go.”
  • Trustees passed a motion to adopt an interim financing loan with the USDA. DeWitt explained these are rate sheets from the USDA outlining what the financing terms will look like under the pending loan. Dewitt described the documents as a routine part of the process.
  • Due to a notable increase in requests for hospital district documents under the Freedom of Information Act, the trustees discussed charging fees to provide the paperwork. Gathering documents frequently took considerable time, pulling district employees away from their regular tasks, Hoffman said.
  • Following an executive session, the board passed a motion to approve its contract with Doorn pending final review by Doorn.

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