From the pages of
Sublette Examiner
Volume 6, Number 32 - November 2, 2006
brought to you online by Pinedale Online

RHCD looks at staffing

by Cat Urbigkit

The Sublette County Rural Health Care District met in Marbleton Wednesday evening, Oct. 25, with all members present with the exception of Walt Bousman.

When RHCD Director Randy Johnson explained to the board that the minutes of the last meeting weren’t yet ready, board Chairman Bill Budd expressed his displeasure.

“Needless to say, I’m not happy with that,” he said, noting that it’s important that the minutes be promptly presented and published in the newspaper.

Kris Roork gave an update on physician search efforts. She reported that one physician and his family came to visit last week; he intends to come to Pinedale. Roork said that all interested candidates have experienced “big sticker shock” at local property values.

Roork said there are three “really dynamic doctors” interested in relocating to Sublette County.

“I’m sure they are going to come,” Roork said, with a January target date to begin work. She noted that all are board-certified and equipped to be leaders in the Pinedale clinic, while taking rotations in Marbleton.

Even with the new doctors, Roork said, “We do lack about three to four staff members.”

Roork said, “The schedule does not include any wiggle room.”

“We have Dr. Kramer also,” Roork said, adding she hopes the district would be able to have him available at least part-time, as well as serving as an advisor to district medical professionals.

“We are stretched,” Roork said. “We have no spare parts.”

RHCD Board Member Dave Racich said it’s “critical” that more coverage be provided so there is some leeway.

Roork said the Marbleton Clinic is also seeing more patients, including more Pinedale patients traveling to Marbleton.

Racich said it was his understanding that one doctor and a locum are seeing 50-60 people per day in Pinedale.

Roork said that one day last week she saw 31 patients in one day.

“It’s too many patients per practitioner in Pinedale right now,” Roork said.

Roork said that Dr. Douglas LaSuer agreed to stay on for a while in Pinedale, possibly a year. LaSuer is seeing patients two days a week as well as administrative duties, according to Roork.

Noting that Nov. 7 is the last day of LaSuer’s contract with the district, the board agreed to pursue LaSuer’s interest in another contract.

Several other significant actions are in the works. Roork noted that the committee of medical professionals in the county would soon be meeting again to develop a use/qualifications policy for use of the district’s emergency rooms. She also suggested the board take action to see about getting more nurses on staff.

Mary Jo Carlson, a nurse working at Wyoming Range Medical, spoke up, telling the board she also currently works in the emergency room in Evanston, but applied several months ago for a nursing job and was told the Marbleton clinic doesn’t need a nurse.

“There are a lot of people wanting to work here, but you’re pushing them away,” she said.

Board Member Garry Eiden said to his knowledge, there have been three nurses who have attempted to apply for jobs, only to be turned away by existing personnel in the Marbleton clinic.

RHCD Board Member Jud Faler personally apologized to Carlson for the way she was treated, saying in his view, as a new board member, such an incident was unacceptable.

Carlson said she also knows of another nurse who isn’t working at the moment because of all the controversy involved with the district.

EMT Carol Mackie responded that there are two sides to issues, noting that “there are political venues” involved in some of the controversies.

Budd said the situation needs to be looked into, adding, “If it’s politics, that’s not going to work.”

The board agreed to ask Pinedale nurse Marilyn Huffman to take on the task of nurse recruitment, speaking highly of Huffman as unbiased and knowledgeable.

Faler broached another topic, suggesting that the board needs to approach Wyoming Range Medical to learn if there is a way the board could contract with them for services in the Marbleton area. Faler suggested that the board form a committee to make the initial contact with the partners in the medical business, asking the board to “work something out to start with, I think it needs to be addressed.”

Racich said, “I agree. They are providing health care in Sublette County.”

Faler noted the district is competing with the private clinic, and losing money in the process.

The board decided to appoint Faler and Eiden as a two-person committee to privately meet with Wyoming Range Medical officials. Budd suggested if the result is that the private business would be interested in working with the district, the board would need a written proposal for formal consideration.

The board had a variety of routine business matters to address, starting with the proposal to have district employees paid via direct deposit rather than paychecks, saving on paperwork associated with checks. The board was told that it can’t force employees to go to direct deposit, and agreed to implement direct deposits for all employees who are willing.

The board briefly considered the possibility of using the old Marbleton Town Hall as living quarters for emergency medical services technicians.

Racich, reflecting on the condition of the building, asked, “Why put the money into it?” Racich said that it wouldn’t be feasible, according to EMS reconnaissance report.

Faler suggested that the board should pursue a new EMS building in the design for the new medical clinic for Marbleton, suggesting the board “get it on the fast track.”

EMT Katie Krieger told the board that the EMTs could make do for a while, with the new building in the works.

Racich suggested that in the meantime, EMS should investigate the possibility of putting in a skid-mount trailer next to the existing structure to provide more temporary housing.

Krieger responded, “It’s worth looking into.”

The board heard a project update of the new Pinedale clinic construction from its newly hired clerk of the works, Brian Gray of WLC of Pinedale. The board entered into an agreement with Gray for his work, with a projected cost of $25,000.

Gray reported that the site work was progressing, but that things will soon shut down for the winter, while steel is being manufactured. Gray said that in the spring, construction would begin.

EMS Supervisor Wil Gay noted that groundbreaking for the new ambulance facility at Sand Draw Industrial Park should occur in November, with actual construction set to begin in January, and an April 1 move-in date.

Johnson reported that interviews are being conducted with the four finalists for the district clerk position, so it should be filled soon.

Johnson reported to the board that the district does not have an objective process in place to handle requests for raises, adding that there are currently 10 such requests pending.

Johnson said he wants to put an evaluation and guideline process in place for raises to be tied to longevity and job performance. The board directed Johnson to develop the process for the board to consider as a district-wide policy.

The board agreed to cancel its second meeting in November, since it was due to fall the eve before Thanksgiving. The board will meet on Nov. 8.

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