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Uncertainty at the RHCD special board meeting

Posted: Wednesday, Nov 21st, 2012

PINEDALE – BBoth staff and citizen concern was palpable at a special meeting of the Sublette County Rural Health Care District (RHCD) board on Tuesday night. A full house of more than 36 people packed the commissioner’s meeting room at the Sublette County Courthouse to hear the board’s decisions regarding system management.

Scott Scherbel, board chairman, clarified the purpose of the meeting for the anxious crowd.

“There was some confusion last board meeting,” he said.

He confirmed the former CEO, Rob Harding, had been terminated without prior cause. He continued to add the special meeting would be limited to organizational administrational items.

“This meeting has been held to decide a course of action; there has been no decision made regarding a new CEO,” he added. “This is a stop gap.”

The board presented a list of eight items to address over the course of the meeting.

Who is in charge?

“There are ideas that are floating around,” Board member Kristin Roork stated.

The board agreed, in the interim, the medical directors should be in charge, taking over partial CEO duties. The board will assume limited CEO duties as well, taking on the responsibility of financial and other unforeseen decisions.

“We have capable people,” Board member Laura Clark said. “It is a matter of prudence and responsibility to hire an interim CEO.”

Scherbel verbalized his agreement that a temporary CEO needs to be recruited. He reiterated the district’s need to start over and get back on track.

As a preliminary decision, it was decided managers will continue to do their jobs and will now report to the board instead of the CEO. The board will begin serious discussion to recruit a temporary CEO, though no decision was formalized if a full-time CEO would be brought on board in the future or whether the district will operate without a CEO in place.

If medical personnel have questions to be brought to the board, they will first contact Scherbel, Racich second and Roork third.

Compliance officer and compliance committee

The CEO has historically functioned as the compliance officer. Discussion centered around the proposal that each clinic’s medical director take over the responsibilities of insuring his respective clinic is in compliance with state and federal laws.

At one point, the need for a compliance policy and the subsequent committee was questioned.

“We definitely need to keep the policy, committee and officers” Clark said, adding, “There are medical and legal issues if we don’t.”

Further discussion was tabled until the Dec. 19 meeting.

Electronic Medical Records (EMR)

The EMR transition was another hot topic of the evening. Implementation is going as planned, but concern was expressed that the programming chosen is antiquated and difficult to use.

“We are encountering a horrific amount of technical issues interfacing with Saint Johns,” stated Gretchen Schmid, nursing director.

The decision was made to hire a contract IT/software specialist for a minimum of one year to aid in the transition. The district will proceed with the use of Centricity, the EMR system already purchased. The idea of moving back the transition date was discussed and will be looked into by the EMR team, possibly allowing for a smoother transition.

Staffing needs

Due to the fact that practitioners may have to take on additional responsibilities in their departments while the district operates without a CEO, staffing needs were brought up.

Big Piney/Marbleton Clinic Medical Director Dr. Burnett would like to see another doctor in the Big Piney/Marbleton Clinic, and physician David Kappenman added he would like to see another in Pinedale.

A coder/biller position is currently being advertised.

Resident Cindy Van stated she would like to see more female doctors in the Pinedale Clinic, a thought that was heartily echoed throughout the room.


The medical directors will retain the ability to hire and fire at will. The board will take over the hiring and firing of managers, directors and contractors.

Reports to Board

Department managers will come to each board meeting and report directly to the board.


The website will continue as planned. Public suggestions are welcomed.


Harding had been in charge of locum contracts. Several are slated to work in January but do not yet have contracts in place. The board will work to remedy the situation and get contracts in place.

The board’s list sorted, resident Chauncey Goodrich summed up the feelings of many people in the room.

“The citizens trust the board, but we can feel the nervousness of each area being talked about. There is no system in place as regards what direction it’s going to go. I’d like to encourage the new board members to go ahead and elect a real CEO,” he said. “It’s concerning to me as a citizen that we can make that rash of a decision without regards as to where it’s going.”

Minutes later, Roork offered a reply.

“This board assembled today to assure everyone we are not going to disassemble [the district] and reorganize,” she said.

Ali Carroll, site coordinator for the Big Piney/Marbleton Clinic, expressed her concern.

“It’s not fine. People are very worried in the clinics. It’s going to get in the way of patient care if people are concerned over their jobs,” she said.

Board member Mandy Norris stated the board realizes they need to move forward in a positive way and “make things really come together.”

Scherbel seconded the thought.

“This has not been an easy task for the board either but we felt it was essential,” he said. “This is not a medical health care issue but an administrative issue. Continue to provide great health care service. Step up and take the challenge.”

The next regular meeting of the RHCD will be held Dec. 19 at 7 p.m. at the Marbleton Town Hall.

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