SUBLETTE COUNTY – The Sublette County Hospital District Board of Trustees, during its April 27 meeting, approved a “modest” 2.3-percent fee increase for certain services performed at the clinics during its April 27 meeting. The motion included language committing the district to study fees and options to assist clients in need, particularly uninsured and underinsured patients, with the higher fees.

“We are looking at ways to better serve the underinsured and uninsured population” in Sublette County, said board chairwoman Tonia Hoffman.

Mike Hunsaker, chief operating officer for the SCHD and its management partner, Star Valley Health, emphasized that the 2.3-percent rise in rates was not an across-the-board rate hike.

“This (increase) is for a select number of CPT (current procedural terminology) codes or services where we are below the insurance companies’ ability to reimburse (for that service),” he added.

The board finance committee met multiple times over the past months to examine the district’s fee schedule, said Kenda Tanner, board secretary-treasurer and member of the finance committee. The committee realized the district was charging “less than what insurance companies reimburse” for some services.

“What that essentially means is we are leaving a little bit of money on the table there,” she added.

The district compared its fee schedule with hospitals in Kemmerer, Rock Springs and Jackson and found SCHD was charging “considerably lower than the average fees in the surrounding areas,” Tanner added.

“If we don’t implement regular fee adjustments, we can’t expect to keep up with inflation or cost increases, be able to give staff raises or protect longevity,” she said.

The 2.3-percent rise in rates equated to an average of “just over $5 per patient encounter,” Tanner told the board. That is still lower than average regional fees but a “good place to start” in meeting district needs.

New internist to start

Dr. Rafael Hastey, an internal medicine physician, is scheduled to begin work with the SCHD on June 1, said administrator Dave Doorn.

Dr. Hastey will take patients five days a week at both the Pinedale and Marbleton-Big Piney clinics, Hunsaker added.

Internists care for adults of all ages, Hunsaker explained, and specialize in helping patients manage long-term medical conditions like diabetes or congestive heart disease.

“We’re really thrilled about the opportunity to have this type of medicine here in Sublette County,” he said. “I think it’s a really good thing for the adult population, and the senior population specifically, to not have to go seek internal medicine outside the community.”

Hoffman called the hire a “fantastic addition to our menu of services.”

Doorn repeated the statement he made last month that both nursing and laboratory departments were fully staffed. The district hired a paramedic to help cover on-call weekend shifts for the emergency room, decreasing the extra workload for nursing staff, Doorn said.

USDA and Marbleton-Big Piney Clinic update

The USDA continues to request additional information from the district, Doorn reported. He thanked Rep. Albert Sommers, commissioner Tom Noble, Abram Pearce with the Town of Pinedale and Jorgensen’s for helping the district compile data on a range of issues from wetland to traffic studies.

SCHD administrators did not speculate on a potential date when the final USDA loan application package will go before the national committee.

Hunsaker said the USDA requests for further information were from the national office, a “positive sign.”

“The people asking the questions are the ones making the decisions in Washington, D.C.,” he added.

Doorn also provided an update on the process to obtain free-standing emergency room status for the Marbleton-Big Piney Clinic. Doorn met with Davis Architects and came to the conclusion the remodel would be more extensive than splitting the existing lobby and could involve moving the entire laboratory. He hoped to get new cost estimates for the project soon.

Additional board news

Dr. David Burnett, SCHD medical director, outlined plans for the addition of a pain coordinator to review documents and ensure national regulations on opioid prescriptions were followed.

Burnett called opioid abuse a “critical problem” in the state and nation. The pain coordinator would help providers with treatment decisions and compliance with opioid mandates from the Centers for Medicare and Medicaid Services, to create consistency for patients and protect the board and district from liability, he said.

The district received an additional $89,000 grant from the Federal Emergency Management Agency, said Kari DeWitt, public relations director and grant writer, bringing the total amount of grants the district has received since July to $1.2 million.

Board members unanimously passed a motion to purchase a cardio-ECHO attachment for the new ultrasound machine at the Pinedale Clinic. The older ultrasound instrument was transferred to the Big Piney-Marbleton Clinic, where it is already in use.

Trustees voted to approve a bid from Karl Lueschow of Lueschow Project Management to serve as the district’s owner’s representative. An owner’s representative advocates for the project owner’s funds during the construction process by obtaining cost-effective deals on goods and materials, DeWitt explained.