New ambulance purchased for county's fleet

MARBLETON – Ambulances suffer additional wear and tear in rural, isolated settings like Sublette County. The medical units cover long distances to care for patients, eating up mileage and requiring frequent maintenance.

An older ambulance in the Sublette County Hospital District's fleet blew out its motor for the fifth time, EMS director Bill Kluck told the board of trustees on Dec. 15.

Board secretary and treasurer Kenda Tanner said the finance committee met with Kluck to discuss options to replace the aging vehicle.

Kluck conducted a nationwide search and located a 2014 model F450 ambulance in Minnesota with only 15,000 miles on the market for $140,000.

An energy company in North Dakota put the ambulance up for sale. It was one of three vehicles purchased during the energy boom, Kluck said. The owners relied on one unit and were eager to sell the other two, he added.

Kluck estimated the price tag for a new ambulance was approximately $250,000. The wait time for a unit to arrive fresh off the assembly line was around 18 months, he said.

The finance committee looked into rebuilding one of the older ambulances in the fleet, harvesting parts from an out-of- service unit, Tanner said. Quotes to remount an aging vehicle ran higher than the cost to buy the 2014 ambulance Kluck located, Tanner added.

Kluck said EMS experienced longer wait times to receive maintenance on older buses. Kluck and Tanner recommended the board to purchase the gently used 2014 F450 ambulance. Trustees complied and unanimously voted to amend the budget to buy the unit for $140,000.

Trustee Dave Bell thanked Kluck for doing his “due diligence” in searching the market to locate what board chairwoman Tonia Hoffman called a “phenomenal deal.”

Dave Doorn, SCHD administrative director, stated the purchase allowed the district to operate two relatively new ambulances.

Aging ambulances remained a “major concern,” Doorn said. He and Tanner encouraged the board to come up with a plan to replace other units running well in excess of 100,000 miles.

New medical director

Following a lengthy executive session, Hoffman announced the board's intent to offer a contract to Dr. David Burnett as medical director over both the Pinedale and Big Piney-Marbleton clinics. The goal was to improve “cohesion” between medical staff at the clinics, Hoffman added.

Providers at the Hospital District typically fill the medical director role, and hiring someone from the outside would lighten providers' load and provide a fresh set of eyes, Doorn said.

Burnett emphasized his past experience as a physician serving Sublette County for many years. He looked forward to finding ways to improve patient care and exploring “new directions” to help SCHD staff and providers navigate the difficulties and changes they faced.

Burnett said he was happy to “do anything I can to sustain the hospital project.”

“I'm glad to help and I will give it my best effort,” he added.

Reelection of board officers

Hoffman opened the floor to select officers for 2022 on Dec. 15.

The board passed a unanimous motion to retain the current officers – Hoffman as board chairwoman, Jamison Ziegler as vice-chair and Tanner as secretary-treasurer.

USDA and vaccine mandate updates

Due to the holiday season, the SCHD's loan application to build a critical access hospital through the U.S. Department of Agriculture was expected to go before the national board in January, Doorn reported.

Hoffman stated that progress on building plans and the merger between the SCHD and Sublette Center were on hold pending a final decision from the USDA.

Hoffman updated the board on the federal vaccine mandate for health-care employees working at facilities participating in Medicare and Medicaid. The mandate raised concern and discussion at the Hospital District's November board meeting.

The U.S. District Court, Eastern District of Missouri, issued an injunction on Nov. 29 halting the federal government's requirement that health-care workers without a valid exemption receive vaccinations by Jan. 4.

The ruling covered 10 states, including Wyoming. The injunction is temporary, and legal action around the proposed vaccine mandate is ongoing. On Thursday, Dec. 16, the Biden administration asked the Supreme Court to intervene and allow the federal government to enforce the vaccine mandate.

Hoffman stated the injunction “bought time” for the SCHD. She and Bell continued to work with the district's attorneys to “be proactive” and plan for the possibility the injunction against the mandate might be overturned.

SCHD administrators had collected and filed employee exemption requests in preparation for any changes, Doorn added.

Staffing shortages continue

The nationwide struggle to find nurses remains a problem in Sublette County. Vicky Marshall, nursing manager, said the district “continued to do the best we can” to recruit nurses. Several of the few candidates applying chose to accept higher- paying traveling nurse positions, Marshall said.

Marshall thanked EMS staff for stepping up to help in emergency room situations. The Hospital District was down to four RNs to cover both clinics and be on call 24 hours a day, 365 days a year, Marshall told the board.

“We are getting tired,” she said.

Doorn reported progress on plans developed by Sharon Rutsch, clinical services coordinator and laboratory director, to retrain laboratory staff in the district as certified medical laboratory techs through Casper College.

Rutsch came up with the idea to allow laboratory staff to continue their work for the clinics while furthering their education without the need to leave Sublette County.

Doorn and Rutsch visited the laboratories at Casper College to make sure facilities in Sublette County were “in line” with the program's requirements, Doorn said.

Rutsch's idea was attracting positive attention from the state, and Doorn told the board he hoped to use the model to retain and train radiology staff and nurses in the future.