MARBLETON – It was a busy night full of many discussions as the Sublette County Rural Health Care District (RHCD) board met for its regular monthly meeting Wednesday at the Marbleton Town Hall.

Of the numerous topics brought up throughout the lengthy five-hour meeting, consultant Susan Barney’s recent work to survey the sentiments and legitimate concerns from a small, yet vocal, group of residents in Big Piney and Marbleton rose to the forefront.

Barney, a small-business consultant, operates Taliesin Consulting and was hired by the RHCD board for the Phase I gathering of feedback about those residents’ perceptions of the RHCD board, administration and critical access hospital (CAH).

Barney interviewed and held a “round table” meeting with about 25 South County residents.

What she heard was that these people have lost faith in the RHCD board and administration due to a perceived lack of transparency, fiscally unsound actions and poor communication with the public.

“There was a concern that decisions which may affect the quality and availability of care are being made without community knowledge, understanding or involvement and impacting financials,” Barney said. “For instance, the decision to reduce South County EMS. For many people, that seemed to come out of the blue. There are a lot of rumors. The rumor mill has a lot of things wrong, but these are the perceptions of people in the community.”

In addition, Barney reported that the RHCD’s affiliation agreement with St. John’s doesn’t seem to be well explained, and she urged the board to do a better job of marketing its information.

Due to a high number of emergency board meetings – including the surprise special meeting on a Sunday, March 19 – Barney said people she interviewed are concerned that “nefarious” things go on and the reasons for special meetings are not clearly communicated.

“There are ways of communicating things that are important,” she said.

Barney also reported that many residents distrust the RHCD board and administration with public funds and feel they need to be monitored. Some of this perception comes from their not understanding how the $102 million collected from the mill levy since 2002 was actually used.

The district’s financials are also difficult to understand and appear inconsistent to them, she related, and the public and RHCD staff lack knowledge of the current administration and board’s efforts to lower operating and administration expenses and improve operations efficiency.

She recommended solutions for the board to consider such as working with an external accountant to review the RHCD’s previous 12 years of spending to explain where the money went, along with the business model and cost structures in place then that led to high expenditures.

The report also touched on CAH perception, stating some believe the CAH will not be a “real” hospital with quality health care.

Barney met with Sublette County commissioners Dr. David Burnett and Mack Rawhouser, both from the Big Piney/ Marbleton area, and learned they support moving forward with the CAH; however, they were not yet convinced of the business case.

“County commissioners were waiting for a formal proposal (business plan) and engineering study in order to understand the business case and financials before voting,” she said. “Although they had indicated to me a lack of buy-in, they did view themselves as supporting the RCHD in moving to the place where the RCHD board could make a formal proposal to be considered by the commissioners. It appears as though there was a misunderstanding about this, and they became angered when the RCHD forced a vote before officially submitting a formal proposal for consideration. “

Other perceptions include not understanding the financial rationale behind the CAH and that the CAH business model’s days are numbered due to efforts to change health-care laws.

She suggested having former CAHs’ employees explain how bringing in a CAH would improve quality of life and care residents would receive.

As for the RHCD’s stalemate with county commissioners, Barney suggested they both hash out their differences and apologize for not fully understanding the formal approval process to follow of bringing in an engineering study and business plan. She says the commissioners need a formal business case and presentation.

Barney provided the board with a full list of recommendations to consider for each issue she discovered through her research.

After giving her presentation, she took questions from the board and audience members. One community member asked why the report labeled these issues as being divided by North and South County, adding that people in the north are just as concerned with these issues and that the perception of a county divide would not help public relations.

Barney said she was hired to specifically focus on Big Piney/Marbleton residents, as that is where the most vocal group is from.

RHCD Medical Director Dr. David Kappenman said it is important to talk about this to bring about a solution.

“If we don’t talk about perception, it can go unchecked and fester,” he said.

K&K Marketing and PR, recently hired to assist the RHCD with marketing, had creative director Kimberly Emerson in attendance, who also asked questions.

She asked Barney how many people were interviewed; Barney replied she spoke with approximately 25.

Emerson said that was .003 percent of the county’s population that provided this input.

“I would be hesitant to make decisions on a small sample size,” Emerson said.

RHCD vice chair Scott Scherbel responded, stating the proposal made to Barney was to seek out those less supportive of the CAH in Big Piney/Marbleton and that the board expected a biased report to come out of it.

“This is what she was tasked to do,” he noted. “It is a very focused report on a specific group of people.”

After that hour-long discussion, the board suggested Barney get together with K&K Marketing and PR, ideally before the next regular meeting on July 19 in Pinedale, and bring a proposal before it moves on to Phase 2.

Much more than Barney’s Phase 1 report was discussed throughout the lengthy meeting. An expanded article covering more of the meeting will be in the Tuesday, June 27, edition of the Sublette Examiner.

Also occurring on Tuesday, June 27, Michael Curtis of Neenan Archistruction and Charles Ervin of Dougherty Mortgage will make a presentation to provide insight on the next steps moving forward with the CAH. The presentation will be held in the Pinedale Library’s Lovatt Room from 7-8 p.m.