Out with the old, in with the new

Sublette County Rural Health Care Board dumps mediation

PINEDALE – In October, former members

of the Sublette County Rural Health

Care District Board voted to pursue mediation

after the U.S. Department of Agriculture

Community Programs Director

Lorraine Werner denied its $25,461,000

loan application to build a critical access

hospital at the BloomField site.

An election later, with four new members,

the board voted not to mediate at its

first official meeting Monday, Nov. 19.

They also voted to remove the $100,000

earnest money that the previous board put

in an escrow account and return it to the

district’s bank account, because, for them,

financing for the BloomField site is no longer

an option.

New trustee Bill Johnson said, “If we

do another grant application it will be for

a different site.”

New chairman Wendy Boman corrected

him, saying, “When we do another application.”

Attorney Doug Mason was authorized to

notify the seller, finance company, USDA

and a list of others impacted by the decision

of the change.

Pinedale Clinic Medical Director Dr.

David Kappenman asked from the audience

when the board would pursue other

options. He said finances are getting tight

and the two clinics operated by the district

are losing reserves and the situation is demoralizing

for staff. He said 30 percent of

the population is on Medicare and Medicaid

but that population makes up 60 percent

of the patients seen by the clinics. Those

entities don’t reimburse charges in full at

the clinics at the same levels they would

reimburse a hospital.

Earlier in the meeting it was explained

the clinics are only paid about 30 percent

of charges by government entities, resulting

in large write-offs.

New trustee Tonia Hoffman said she

was unwilling to jump in right away and

pursue hospital plans and the trustees may

wait a year “for dust to settle” following

the contentious election. She said the voters

spoke at the election and told them they

didn’t want the hospital as planned.

Kappenman said, “If it’s a year, I’m out

of here.”

He encouraged them to move forward


New trustee Mike Pompy said he was

waiting until the newly elected county

commissioner is seated in January. Doug

Vickrey, elected to the county commission,

was in the audience for the health care

board meeting, but made no comments.

“I’m ready to hit the ground running,”

Pompy said. “If we do a better job up here

with an application, maybe the USDA will

approve it the first time.”

Johnson said the board has more important

work first.

“We need to take a look at expenses,”

Johnson said. “I don’t think we need to cut

people, but look at positions.”

He compared it to his former job at BTI.

“If we weren’t busy we sold vehicles and

cut positions.”

Kappenman said unlike that company,

for heath care the district was getting 40

cents on the dollar. He said BTI would

move as quickly as possible and make necessary

changes to get paid 101 percent on

a dollar for services charged by becoming

a hospital.

Boman added she felt after talking with

commissioners the two entities would be

more willing to work together – even continue

leasing the current clinics as the hospital

is built, saving the $3.95 million to

purchase the clinic.

Hoffman said she is happy with the providers

and did not want to run any of them


The meeting of four new members began

as they elected new officers. Boman, the

only one to previously serve on the board,

was nominated and elected chairman. Johnson

was elected vice chairman and Hoffman

was elected secretary-treasurer.

Even approving minutes was unattainable

because only Boman remained from

the previous board and there was not a majority

to vote on the past meeting’s minutes.

Other actions taken by the board included:

• The board went into a closed executive

session to discuss personnel. All employees

and the board’s attorney were excluded

from the meeting. No actions were taken

following the closed meeting.

• The board requested board training for

open meeting and public records laws.

• A 2019 board meeting schedule was

approved. Pompy requested meetings

planned for Big Piney be moved to the

Marbleton Town Hall to facilitate better

sound and more seating.

• A 2019 holiday schedule was approved

with eight paid holidays, the same as past


• Financial reports were approved including

current expenses through October

2018 of $2.8 million and revenue of

$953,105 for a net loss of $1.879 million.

The actual budgeted loss was predicted to

be $6.5 million. The budget reflected ex

penses for the critical access hospital being

moved from the administrative expense account

to a capital expense account.

• A snapshot was summarized for October

2018 patients including 929 total patients

in the Pinedale Clinic and 433 visits

in the Marbleton Clinic.

• Job descriptions were approved for administrative

assistant and patient accounts


• The district received an Axcel machine

from Alfa Wasserman for the Pinedale

Clinic. The donation includes training

and initial supplies. The machine is used to

measure preclinical tests. The company had

already provided a machine for the Marbleton


• Boman informed Bill Kluck with

Emergency Medical Services that she had

received calls about a helicopter flying low

over homes. Kluck said he has spoken with

helicopter pilots for providers. When the

wind blows from some directions helicopters

are unable to navigate the light poles

from the ball fields and must approach the

landing pad from above the homes. He

added, pilots are required to circle a projected

landing area based on Federal Aviation

Administration rules and evaluate

hazards before landing.


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