Minimum standards under review

by Cat Urbigkit

The Sublette County Rural Health Care District Board met in Marbleton Wednesday night, Nov. 8, with all members present.

RHCD Director Randy Johnson told the board that in their packets was a document containing a set of recommendations for minimum qualifications for professional practice in the county clinics. The board took no action on the recommendations at this time.

The recommendations were developed by the primary care providers who serve on the RHCD medical staff and include Drs. Tam Czarnik, Doug LaSuer, Mike Kramer and Judy Boyle, as well as Physician Assistants Doug Thomas and Kris Roork and Family Nurse Practitioner Leslie Rozier.

The recommendations are:

• All primary care providers (MDs, DOs, PAas and NPs) must be licensed to practice in the State of Wyoming through their regulatory boards (Board of Medicine/Board of Nursing) without practice limitations.

• They must have prescriptive authority through their regulatory boards and have controlled substance certification / registration with the Wyoming State Board of Pharmacy.

• They must have current Drug Enforcement Administration certification.

• All professional primary care providers must be board certified in their area of specialization.

• All primary care providers must be certified in advanced cardiac life support, advanced pediatric life support and advanced trauma life support, or qualified with equivalent certifications, or agrees to complete certification in these areas within six months from the date of hire.

According to the document, the current medical staff agree that these requirements for professional practice as physicians, physician assistants and nurse practitioners who are employed and who are considering employment with the district.

All of the current staff and newly contracted staff are in compliance with the requirements.

In other business, Lorraine Gatzke of Big Piney was hired as the district’s chief financial officer, starting in late November.

Board Member Dave Racich suggested that the board be presented with a financial report as soon as possible.

Johnson reported that the administrator search committee would be meeting soon, and that an interview or interviews will be scheduled with the top candidate or candidates.

The board discussed progress on construction of the new clinic at Pinedale and planning for a new clinic in Marbleton. Racich encouraged the public to take a look at the site plan options and provide input. The board will put copies in the library for review.

Pinedale nurse Marilyn Huffman advised the board to hire retired nurse administrator Cindy Van to assist her in assessing nursing needs and filling those staff positions.

The board hired Van as a consultant to establish policy, determine staffing needs and fill the staffing positions.

Board Chairman Bill Budd pushed to get nurses in the Marbleton clinic.

“We don’t have any nurses in the clinic here,” Budd said.

Huffman attempted to not step on the toes of the existing staff at the Marbleton clinic, but Van explained that they would “look at the (full-time employees) that are needed, not the FTEs that are employed.”

Budd said he wanted to be sure that no one would ignore the issue that there have been qualified nurses who have attempted to apply for jobs at the Marbleton clinic, only to be turned away by clinic staff.

Van and Huffman would also put together nursing policy and protocols to be adopted by the board. The adoption of such protocols would set a written standard for patient care, something that has never been in place in either of the county’s taxpayer-funded clinics.

The board also instructed Johnson to apply for designation for the Pinedale clinic as a frontier extended-stay facility. The Pinedale clinic’s location of more than 75 miles from a hospital qualifies for the program, which would provide funding for three years for the clinic to host limited extended stays for patients, rather than immediately releasing them or sending them to another facility.

The board also confirmed that two board members had met with representatives of Wyoming Range Medical to discuss how the board might work with this private medical services provider. Board Member Jud Faler said this was an initial contact discussion involving little detail and said he and Board Member Garry Eiden Sr. hoped to meet with Wyoming Range Medical again soon to continue those discussions.