Rural Health, hospital officials still ironing out details in ambulance pact

By Laurie D. Morstad

Since Oct 12, South Big Horn County Hospital District has been receiving ground ambulance via Guardian Ambulance Service. Chief Executive Efficer John Adlesich and Jeff Grant, chairman of the hospital board, remain committed to signing a contract with Guardian for both ground and air ambulance within the next few weeks.

The board has already approved a payment of $56,784 to the AirMedCare Network for a contract with Guardian Flight for air services for all residents of the hospital district that will go into effect once the ground ambulance contract is also signed and the payment for air services is made.

Since 1990, the Big Horn County Rural Health Care Board No. 1 had been using Atwood’s Ambulance for its ground ambulance. On Oct. 10, 2017, the rural health care board entered into an agreement with South Big Horn County Hospital District to provide those services. In return for this coverage, they agreed to pay $16,000 a month for ambulance maintenance, upkeep, improvements and training.

Deb Rathbun, chair of the rural health board, attended Wednesday night’s hospital board meeting.

“We’ve always had direct contact with our contractor before. If there was a problem we’d pick up the phone and talk,” said Rathbun. “Now we’ve got a third person involved, we got the hospital between us and now with the problems we’re having we have to take it to John (Adlesich) and hope John takes them to Guardian. It puts us in a dangerous situation.”

The problems referenced by Rathbun deal with dependable staffing and response times not being consistent. One example given by Basin’s police chief, Chris Kampbell, involved a 14-minute response time for the ambulance leaving the ambulance bay at the hospital “because there was one Guardian staff here looking for a driver, and that’s not acceptable.”

In response to this, Adelsich stated, “I just talked to the director (of Guardian) before this meeting. They have seven people hired. They started on-boarding a week and one half ago. He said in two weeks they’ll be ready to be on their own, as well as in two weeks they’ll be able to have a backup team available.”

According to Adelsich, most of hires have been part time from local EMTs with either basic or intermediate level of certification. Adelsich has also initiated a check at shift change to verify that Guardian has two staff members in-house. If they do not, Adelsich would be notified to assign a staff member to fill in that day — until Guardian is fully staffed in two weeks. Guardian Ambulance has further assured a 24-hour notice if they are only going to have one staff present.

The hospital district has leased the MS-57 ambulance from the rural health board. Guardian has been upgrading that ambulance and Adelsich stated it would also be ready in two weeks.

Adelsich also informed the board, “In February, they will need to pull their current ambulance because it’s property of Fremont County. When the ambulance they are currently using goes back to Fremont County, then MS-57 becomes the primary and then we will need to purchase a second ambulance, then lease it to Guardian.” This is good news as the radio frequency used by the Guardian on site now is not compatible with all other emergency providers in south Big Horn County. For the next few weeks, Adelsich said he would see if hand-held radios could be used by other responders to communicate as needed to the ambulance driver en route.

Figuring out quarters for the on-site ambulance crew has also been a challenge. At this time, he said, “We are using the old doctor’s sleeping room and two other rooms. Crew quarters have improved and we have showers working and in a private location for them in the evenings. It’s not a long term plan.”

Chairman Jeff Grant responded, “At least until we have the ambulance system working well and the rural health board is comfortable with what we’re doing; it would seem like our only option is something here on the site.”

Adelsich also wanted the board to consider crew quarters at the airport.

“It’s a significant advantage for staffing to have both (air and ground) ambulances at the same place. They would have everything based right there.”

He said he would know more about that option in a couple of months.

Other hospital board business included:

  • Dr. Jenkins Clarkson, OB/GYN with Powell Valley Healthcare, has been sent a “template for a contract” for he and his staff to come to SBHCH three days per month. “That’s a nice add-on for the clinic,” said Grant. Adelsich added, “They are also in our network for employees on our health plan who were to become pregnant.”
  • Tamera Sawyer, director of human resources, reported on the change from Medworx payroll system to ADP. With ADP, the employee can access their pay statements, view the PTO balance, access W-2 information, benefit information, request time off and receive up-to-date communication within the hospital. “We have extended the ‘go live’ date to Jan. 22, 2018. That way employees have more time to get comfortable with the system,” she stated.
  • A motion was passed to allow operations manager Mark Schlattmann to proceed with the project of enclosing the ambulance bay, heating it and providing fire suppression and also request support as needed from an engineer on specs.
  • Adelsich reported on getting a compartment of the hospital approved for memory care. “We have six beds that have doors so we just need to get it cleared with the state. We did a Performa and it’s a good thing for the community and I think the hospital, financially, but it will also provide six beds for patients with dementia. The unit will be totally secure. It will require removing a couple of rooms, the infrastructure is there, we just need to get it approved. We’re seeing an increase in the number of patients with dementia. There is high demand for care of patients with Medicaid only.” The Memory Care Unit will be for patients whose payment source is Medicaid.
  • On Dec. 15, the hospital concluded their open enrollment period for medical benefits with a 94 percent participation rate from eligible employees.
  • The next meeting of the Rural Health Care Board meeting is Jan. 3 at 5:30 p.m.