RHCD: No hospital, but need $6 million construction

by Cat Urbigkit

Facility & Total Cost
Pinedale Medical Clinic $2,356,227
Pinedale ambulance barn $466,523
Marbleton/Big Piney Clinic $2,625,418
Marbleton ambulance barn $584,022

Dave Rhyne and Frank Swaans of Davis Partnership met with the Sublette County Rural Health Care District Board last Friday night to discuss plans for new building construction and additions to existing structures. Although the county commissioners were invited to the session, none of the three attended.

Swaans began the session by noting that one of the issues examined in his firm's feasibility study was whether a hospital would make sense in the county.

"It doesn't pencil out," Swaans concluded.

Swaans said research indicates that the "absolute minimum requirement" to support a hospital is a population of 10,000, with 80 percent of that population located within 10 miles of the hospital.

Even using a high population-growth scenario, the feasibility study estimated that the patient volume in a Sublette County hospital in 2007 would only average five patients per day. Interestingly, the feasibility study estimated that all other communities in the county would experience population growth by 2007, with the exception of Big Piney, which was estimated to have a population drop of 24.

One factor that was in the county's favor when considering a hospital is the age of the county's population, with 12 percent of county residents in the 65 years old or older age group. This group requires three to four-times more medical care than younger age groups, Swaans said.

Swaans also noted that Sublette County residents use hospitals at a lesser rate than does the overall United States population. For comparison, residents of this region had 100 inpatient visits per 1,000, compared to the national average of 117 inpatient visits per 1,000.

Another consideration not in the county's favor when deliberating over a hospital is the issue of market share. Swaans noted some residents would continue to drive to other regional hospitals for their needs, including going to Saint John's in Jackson.

The Davis Partnership feasibility study determined, Swaans said, "Including obstetrics, the population of Sublette County can probably support four to five primary care physicians."

With the hospital question answered and out of the way, Rhyne tackled what needs to happen to the district's existing structures in order to meet future needs. In summary, Marbleton needs a new clinic and attached ambulance barn constructed, while the Pinedale clinic and ambulance barn simply need additions. The estimated cost for all the projects, not including any land purchase need in Marbleton, totals $6 million.

Rhyne explained that the existing Marbleton clinic has no room for expansion and is currently in violation of federal codes, including the Americans with Disabilities Act.

"It's all so packed in there so tight," Rhyne said. "This is a fact that it is not worth saving."

The firm proposed construction of a new 8,900-square-foot medical facility with an attached (or near) ambulance barn for Marbleton. The facility should handle four ambulances as well as decontamination facilities. The site is an issue, with the board needing to purchase property. Rhyne cautioned that the clinic needs obvious highway visibility.

"You need to make it so it's easily found," he said. "I would love for it to be on the main drag, visible for people to be able to find it quickly."

The Pinedale ambulance barn needs to be expanded to include an additional ambulance bay and a decontamination room, as well as added space for a lounge and sleeping quarters, the study indicated.

The Pinedale clinic would be expanded to include space for new offices and exams, a minor procedures room, holding room and staff support rooms and other facilities.

The feasibility study noted the poor air circulation/exchange in the Pinedale clinic.

The board is expected to take the results of the feasibility study into consideration as it begins its budget deliberations.