Hazards, budget over-run discussed

by Cat Urbigkit

Monday night's Sublette County Rural Health Care District Board meeting in Marbleton was largely uneventful, but included pressing concerns, such as hazardous situations for first-responders, and in a completely unrelated matter, a nearly 500-percent cost overrun on a budget item.

First, Dr. Darcy Turner of the Marbleton/Big Piney Clinic spoke with the board about the possibility of the board budgeting money to assist with physician retention and recruitment. Turner suggested that the board allocate money to a fund that would help pay for continued medical education requirements experienced by the county's full-time health care providers. The board asked Turner to put the proposal in writing and present it to the board for consideration during the budget process.

The board read a letter from Pinedale ambulance service supervisor Wil Gay in regard to transporting patients that have been contaminated with a hazardous waste and the possibility that poses to contaminating the entire ambulance.

Gay's letter noted that he had conferred with ambulance services from throughout the region and the advice was, in effect, do not put a contaminated patient in an ambulance because that action could possibly contaminate the crew, making EMTs the patients instead of care providers.

Board Member Bill Barney said the letter proved problematic, since drilling mud is considered a hazardous waste. He said that it would be hard to go to a drilling rig without getting into a hazardous situation.

"So what are the ambulance services to do when they arrive on the scene," Barney asked, when they arrive to find a "mangled guy covered with drilling mud?"

The EMTs in attendance responded that the mangled guy would be loaded into the ambulance and treated for his injuries. It was explained that it is standard protocol for the senior person at the scene to make a judgment call on such matters.

EMTs have annual hazardous waste training, said EMT Katie Krieger. What it comes down to is that person must weigh the relative risks of the specific situation. The patient is either loaded into the ambulance or assistance is requested and the patient is decontaminated on-site.

The next order of business was the board's review of a $24,500 bill for remodeling of the Marbleton EMT mobile home. The board had budgeted $5,000 for work on the mobile home, but in what board members acknowledged were sloppy procedures, the project ran far over the board's rough cost estimate.

The board discussed what had happened in the process in which the contractor had been authorized to go forward without the board approving a project estimate.

Board Member Garry Eiden Sr. said that this board, and numerous boards before it, had discussed and budgeted for the work to be done in the trailer, but the work was never done. He said the board had directed that the work be done, so he worked with a local contractor to see that it was done.

Eiden argued that he had been involved in the process, and that the board didn't have specifications for the work, so when problems were found in the trailer, the contractor resolved them, causing added expenses to the project.

"I think it looks excellent," Eiden said, "and I think it's livable."

EMT Krieger noted that at least four people a week now stay in the mobile home.

Eiden said that that if the board wanted to blame someone, they should blame him because when the board said to get the trailer fixed, he made sure that the job was done.

The board agreed that it should institute a better procedure for such work, with one component being supervision of the work and cost over-runs. Barney said this case simply illustrates what a hired administrator could do for the board.

In other business, the board decided it will not pay mileage for out-of-area EMTs to serve with the local ambulance services, and hired Tex Williams as an ambulance driver for the Marbleton service.The board agreed to hold a policy and procedure meeting at 7 p.m. on March 30 in the Marbleton Fire Hall.