RHCD off to rocky start

by Cat Urbigkit

Transitions can be painful and Monday night’s Sublette County Rural Health Care District Board meeting could be called excruciatingly painful. Newly elected board members were seated for their first major business meeting, with Chairman Bill Budd attempting to define how the board will conduct itself, and muddling through Robert’s Rules of Order. Board Member Walt Bousman was absent from the meeting.

It began when the meeting was called to order and Budd questioned why there were no minutes from the last meeting for the board to approve. Clerk Jauna McGinnis said that she hadn’t had time to prepare the minutes before Monday’s meeting. Budd said that situation needed to be rectified, and suggested that from now on, minutes of the previous meeting should be ready for the board’s next meeting. The past practice of reviewing minutes of six to eight meetings at one time is inadequate, Budd said.

The next item on the agenda was Director Randy Johnson’s update on the physician search for the Pinedale Medical Clinic. Johnson explained that there are three physicians who were interviewed, and a fourth who has requested an interview, but the process was on hold waiting direction from the new board.

Board Member Dave Racich made a motion that the district move forward on follow-up with the interested physicians and try to get someone hired. Board Member Garry Eiden Sr. seconded the motion, but when it came to discussion, Budd said he “doesn’t feel competent” to make a decision about hiring a physician. Budd reported he’d taken the liberty of contacting several medical professionals in the county and asked them to serve as a committee to provide hiring recommendations to the board.

Racich pointed out that some of the medical professionals were in attendance at Monday’s meeting and suggested that they be given a few minutes to provide comments to the board about the county’s current medical situation, but Budd opposed the idea. He said that when people are allowed to comment during the business portion of the meetings, “things can get out of hand.” He said that people can pack a room to have their say and the board can be forced into voting on a matter based on that pressure, only to be sorry later.

“I’m not going to be part of that,” Budd said.

Racich pressed the issue, asking the medical professionals to provide “some insight” for the board, helping the board to assess the urgency of the situation. Racich withdrew his motion seeking to move forward with hiring a physician in lieu of hearing from the medical professionals at the meeting.

Eiden said he also felt it was a great idea to get input from the professionals already in the county, as did Board Member Jud Faler. Budd continued to oppose hearing any input at the meeting, asking Racich, “What are you going to do the next time a group comes and wants to talk?”

Racich said while serving on the board in the past, he was once in a meeting with several hundred upset people “and we let every one of them talk.” He said the meeting went on for hours, but everyone was given their chance to have their say.

Budd said, “Did you accomplish anything from that?” to which Racich responded, “Yes, we did. Most people got off their chest what they needed to say.”

Racich said providing that opportunity to speak and be heard was important, “God bless America, ladies and gentlemen,” to which the room erupted in applause.

Budd responded, “Sounds more like the French to me, if everybody debates everything.”

Budd, not wanting to give the floor for discussion, initially refused to recognize Dr. Judy Boyle, who wanted to speak, but Racich reminded Budd that as chairman, it was the chair who recognizes speakers, or denies that privilege. Budd said, “The biggest and toughest get up and start talking, I guess.”

Boyle took the opening, noting while she wasn’t the biggest and toughest, she had something to say. She said anyone who is functioning under the assumption that the Pinedale clinic is covered during the weekday is “sorely misinformed.” Boyle said that there aren’t enough physicians to cover the day-to-day needs, let alone provide 24-hour-a-day, seven days per week coverage. Boyle added that as it now stands, she would be the only physician in the clinic during the month of October.

Budd asked Boyle if she’d ever thought of submitting a written report to the board, to which Boyle responded that the RHCD office has records of patient loads at the clinic.

Budd responded, “Here we go in buck passing,” prompting Boyle’s retort, “Hey mister, you are rude.”

As other medical professionals had their short says, the board learned that when one doctor leaves the Marbleton clinic next month, there would be no qualified lab director in that facility, another problem to be dealt with.

The board agreed to have the medical professional committee meet to provide hiring recommendations to the board, hopefully by the board’s Sept. 25 meeting.

The board learned that the search for a district administrator continues, with Johnson saying he “couldn’t overstate the need” to get someone hired. The board decided to examine the possibility of hiring someone part-time until the full-time position could be filled.

The board was unanimous in voting to proceed with construction of the new clinic in Pinedale. Budd said he was also serving notice of his hope to move into a new Marbleton clinic soon as well

Racich was successful at getting the board seeking to hire a “clerk of the works” to oversee the board’s interests as construction proceeds day to day. Several local possibilities were discussed. The board agreed to advertise for anyone interested in serving in that role.

Pinedale resident Cindy Van, a registered nurse, brought three issues to the board for consideration. She expressed concern about access to quality health-care providers and suggested several possible solutions to the problem, including having a separate emergency/urgent care section of the clinics and staffed by MDs. She also suggested that physicians want-ing privileges in the clinics should be board-certified and that the emergency rooms should seek state licensing as trauma receiving centers.

The board noted they wanted time to study Van’s suggestions, but also agreed to invite Dr. Michael Kramer to come to a board meeting to discuss emergency room issues.