RHCD plan: oversee clinics

by Cat Urbigkit

At its meeting Monday night, the Sublette County Rural Health Care District Board began moving closer toward having a paid administrator, which immediately generated controversy.

The issue was broached as a simple general business question: whether the board wanted to send a letter to the emergency medical technicians and clinic contracting physicians to get their input. The board also discussed formation of a committee to get community input.

The letter had already been drafted and was before the board, but those in the audience had not seen its contents.

Big Piney's Dr. David Burnett questioned if the board had any idea what it wanted an administrator's role to be, or if the board didn't "have any clear-cut direction," was it convening a committee to give it that direction.

Board Chairman Walt Bousman responded that considering that the district's budget is no longer in the hundred thousands, but is now in the millions, he doesn't feel the existing board structure provides the needed checks and balances, so an administrator needs to be considered.

Bousman also added that when it comes to personnel issues, he doesn't feel the board members should be involved in personnel issues, that there "should be someone in between."

Board Member Bill Barney said while "some of us may have some very strong personal views" about what role an administrator should play, he felt an administrator "could be useful."

"It never hurts to have ideas that aren't your own to work with," Barney said.

Barney emphasized that the administrator wouldn't be involved in the business of the clinics. He noted that the medical clinics are operated with private contractors.

"It is illegal and inappropriate for a member, an employee of this board, to get directly involved in your business," Barney told Burnett.

Barney said that boards are supposed to provide policy and guidance, and not get involved in the daily operations.

"That's totally inappropriate," Barney said, adding that the board is increasingly involved in operations and "It's incumbent on us to change that."

Board Member Jerry Jensen said he agreed with the points made by Bousman and Barney. He said that in his view, the clinics would remain under private contract, while the administrator would handle other district operations and the ambulance services. He said an administrator could "maybe eliminate some problems the board has had in the past."

Board Member Mary Lynn Worl said she viewed the administrator discussion as "a brainstorming process" in which the board could get ideas from the medical community, the board and the citizen committee that will be formed.

She said after the process is completed, "We could hopefully come to some kind of consensus and move forward."

At the Examiner's request, the board released the letter for review. Burnett looked at it and was immediately alarmed.

Although the board had said the clinics weren't under consideration for the administrator's responsibilities, the letter began: "The Sublette County Rural Health Care District desires to move towards hiring an administrator to oversee the clinics and EMS services. It is realized that this is a major departure from the way business is currently run."

When challenged by Burnett, the board defended itself, stating that it was not the board's intention to involve the clinics, but the letter was worded the way that it was in order to generate discussion.

Burnett quoted the letter's "to oversee the clinics and the EMS services."

"It's asking you for your opinion," Bousman told Burnett.

Burnett responded: "Wrong - that's your statement of desire right there."

"This is not the way you answered my question," Burnett said, adding that the letter directly contradicted Barney's statements made earlier in the meeting.

Robin Miley told the board it appears that it wants to hire an administrator to serve as a go-between, to act as a buffer between the board and the public, the board and the physicians, and the board and the EMTs.

"You folks were elected to the board ... If it gets too hot, you need to get out," Miley said.

The board drew the discussion to a conclusion, agreeing that after discussing names with other board members, Bousman will propose the names of community members to serve on the committee at the board's next meeting. Anyone interested in serving should contact Bousman or another board member to have his or her name under consideration. Robin Miley, in attendance at the meeting, agreed to throw his name in the hat.

The letter asks questions about the advantages and disadvantages of an administrator; possible qualifications; and duties and responsibilities of an administrator.

The letter asks, "How do you view compensation, duties and responsibilities for the physicians?"

The letter also asks which of the following should be included in the administrator's job: overseeing the financial tasks and records for the district as a whole, as well as the clinics and ambulance services; regulatory compliance; procurement of supplies and equipment; personnel supervision; oversee maintenance and repair of buildings and equipment; communications and public relations; and planning.

The board will discuss the issue further at its Feb. 9 meeting in Pinedale. At that time, the board is expected to vote on who should serve on the committee to examine the issue.