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
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
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
“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
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
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.