A smaller crowd gathered at the South Big Horn County Hospital District board meeting on Wednesday, April 26. About 10 people attended the meeting compared to the near 200 people the previous month.
Those who had some questions for the board were told they would need to submit their questions to the board and the hospital in writing.
“We are not going to be doing this Q&A and integrating in a meeting, we just aren’t going to do it,” said board chairman Jeff Grant.
“All we are looking for is answers and we haven’t been getting answers,” added Bob Paxton.
“I don’t know how else we could do it,” Grant said. “If you’ve got questions, tell us in writing. We don’t want something to be misconstrued by us. We don’t want it to be misconstrued in the paper. We want to be able to respond to you and answer your question.”
Some asked about the current DEA investigation the hospital is currently cooperating with.
“We don’t know and that is all I can tell you,” said Grant. “We may not know anything from the DEA for months. If you guys are impatient, so are we. We have no idea what is going to happen. They haven’t communicated to us. And they will not communicate anything to us until an end result. It is not a ‘we can’t tell you, we don’ know anything.’”
Some in attendance added that there are other issues outside the DEA investigation that they are concerned about.
“The people that are no longer here, they are not coming back,” said Grant.
Grant added that if the public has questions they could submit questions in writing as long as it doesn’t deal with staffing or other human resource related issues.
“You guys are citizens of the community. You have every right to participate in an open meeting. That doesn’t mean we have Q&A at every meeting,” said Grant. “We weren’t even going to do this. I thought things were going to be OK and we could answer a couple of questions.
“We allowed someone to step up in February and I almost go shot. We allowed it in March because the passions were so heavy we wanted you guys to have the ability to share those passions with us. But we are not going to have meetings where people come and make statements and do that sort of thing. If you have questions, we would like to talk to you about your concerns.”
Hospital CEO John Adlesich said after the meeting that those who would like to request to be on the agenda for board meetings would need to contact the hospital to be placed on the agenda to address the board.
New board member, new providers and new clinic
Following board meeting in March, board member Lisa Reesy resigned, leaving a vacant seat on the board of trustees for the hospital. The board and the hospital have been looking to fill the vacant seat for the past month and have been accepting letters of intent.
The board met with three candidates before the public board meeting on Wednesday and interviewed Mitch Shelhamer, Richard Burton and Connie Werbelow.
“We have made the decision to have Mitch join us,” said Grant.
Shelhamer will fill out the term until the next election, in 2018.
In December the hospital was in talks with their neighbors, the Shelhamer family, on a possible trade or lot line adjustment to put the lagoon in the back corner of the hospital’s grounds instead of the front lot.
According to Adlesich, the hospital has not been in talks with the Shelhamers for the past few months about a land exchange.
“We have enough space for the lagoon on our property,” said Adlesich.
The lagoon project is still moving forward and the hospital is waiting on DEQ approval.
The hospital will be getting new providers this summer. Mary Freund will be joining the hospital staff as a provider in mid-May, and Dr. Deborah Brackett will be joining the hospital in July.
The hospital is still recruiting for a third provider to fill an open spot. Dr. Ricardo Ramos, M.D., who is temporarily filling in at the hospital, will be staying on until July.
The board also voted to open a temporary construction loan at a local bank. The hospital is currently planning the construction of their new clinic and administration in the most recent phase of the hospital update and expansion.
This phase will roughly cost a little more than $2 million. The hospital will receive $1 million from the USDA after completion and will receive $500,000 from the Wyoming SLIB board. The hospital will also be investing their own $500,000 into the project.
The new phase would include adding new administration offices, physical therapy, reception and main entrance.
They are setting up a temporary construction loan because of USDA requirements. The USDA will not give any funds until completion.
After this phase comes partial demolition.
Carrie Lowe, who manages Midway Clinic, addressed the board about the progress in the clinic and making the clinic a BFC Clinic, which would mean the clinic would be a place for patients to get their immunizations.
“We want to see patients from birth on up,” said Lowe.
Lowe added they hope to get approval to be a BFC Clinic in the next few months.
Concerned citizen Randi Noble, who was in attendance at the meeting, asked who would be administering the shots to patients.
“Three weeks ago I brought my son out here and there were no longer nurses; there were medical assistants,” said Noble. A medical assistant checked in my son and he was weighed. His weight was written down as 74 pounds. I said that is not correct, my son weighs 64 pound. And trust me I watch that very closely. That is crucial.”
She added that the medical assistant wrote down the wrong weight for her son anyway and said that the scales were old and the hospital is getting new ones.
“Now I have a little 11-year-old boy that has catastrophic medical issues, and you are prescribing medication based on weight,” said Noble. “A 15-pound difference is huge. I’m interested in who will be administering those immunizations. Will it be a nurse or a medical assistant?”
She added that she is sure the change is a cost saving effort for the hospital and asked if the savings was being extended on bills.
Lowe stated that RNs are on site along with medical assistants and an RN or LPN administers drugs that need to be administered.
“I have a lot of concern about that and have been vocal about that,” said board member Margie Triplett. “Working at Billings Clinic over in Cody I have talked to all the MAs and RNs. There are certain protocols a facility has to adopt in order to give the MAs certain responsibilities and they have to be trained and certified to do those things. They also have to go through continuing education every year in order stay current.”
She added that providers, nurses and administration would have to come up with a protocol for MAs.
Noble said she isn’t certain she is comfortable with MAs giving her son an injection because the MA she encountered could not weigh her son correctly.
“That is a huge red flag to me,” said Noble. “And I’m sorry. I’m going to be vocal about that in the community and you all know word of mouth in a small community is either going to kill you or it’s going to help you.”
“We are trying to do what we can. As a board we can’t be here and watch every move. We are keeping our hand on the pulse of what they are doing by asking questions,” said Triplett.
“I feel very strongly that you all were elected and are legally bound to represent the very best interest in this community,” said Noble.
“That is what we are trying to do,” said board member Sue Antley.
Noble questioned whether by doing away with proper nurses and putting in medical assistants that the board is doing the best thing for the community.
Antley added that they are adding nurses as they can.
“I can tell you, of all the people that have left this facility in the past year, you know how many we would rehire? Two. They all needed to go. I’m sorry,” said Antley.
“You keep saying that, but there is no proof of that,” said Noble.
Grant and Antley said they needed to move on.
“Let me say something, I didn’t intend to have this questions answer because it’s not appropriate at a meeting like this,” Grant said. “And I sympathize. You should be as passionate as you need to be about your son. I believe that from the bottom of my heart. I’m uncomfortable talking about individual patients.”
He added that the way the clinic operated in the past was not how most clinics operate.
“The fact that changes have been made does not mean that the changes have led us into something bad. It has led us into something different,” said Grant.
He added that some clinics run just off of physician’s assistants, but the board has made the decision to bring in more medical doctors to the facility, which is more of a cost.
He also stated that concerned members of the public should submit their questions in writing and the hospital will respond back to them.