Health Board Approves $1-Million Budget, Upbeat as Physician Interviews Continue

Directors of Lake Fork Health Service District approved a 2018 budget anticipating revenues slightly exceeding $1-million and expenditures in the $970,000 range at their morning meeting last Monday, December 11.
Board treasurer Becky Campbell breathed a visual sigh of relief in presenting the completed budget and, in her role on the interview committee to name a replacement for Dr. Beuford Durmon, presented an upbeat assessment as interviews continue with promising applicants.
Formal interview with one of the applicants, Dr. Nicholson, took place earlier this month and “went well,” according to Campbell. She continued by noting that Dr. Gina Carr, a physician from Buena Vista, Colorado, was here last week with her husband, Brian, who is a school teacher in Buena Vista.
Campbell’s glowing assessment that she had heard “nothing but positive responses” during Dr. Carr’s visit to Lake City was seconded by audience member and fellow interview committee member Nancy Zeller. “I’d agree with that.”
In terms of promising applicants for the medical director position, Campbell reported, “Things are definitely looking up.”
Dr. Carr was formally interviewed as an applicant for the medical director post at the local clinic last Monday afternoon. Also scheduled for a Lake City visit this month is an Angel Fire, New Mexico, resident whose application, according to Campbell, is contingent on student loans in order to be considered for the position.
Campbell and interview committee members Janel Warren, Dr. Beuford Durmon, Jerry Gray, Dr. Clyde Rutherford, Physician Assistant Bob Downs and Family Nurse Practitioner Sherry Huisman have previously indicated that they are in hopes a replacement for Dr. Durmon can by hired by May, 2018.
In other topics at their December 11 meeting, health board directors Shawna Shidler, Jerry Johnson, Janel Warren, Mike Schell and Becky Campbell heard that $10,000 has been budgeted for next spring’s health service district election.
Jessica Whiddon has been designated as election official in advance of pending legal notices announcing the May, 2018, election and self-nomination of candidates which will begin in February. With the exception of board chairperson Shawna Shidler, who is not up for election, the remaining four health district board directors — Johnson, Schell, Warren and Campbell — have terms which expire in May.
Terms of election are one two-year term and three four-year terms.
Discussion items during the health board’s hour-long workshop, followed by a 45-minute meeting, included reaffirmation that the clinic’s three regular part-time employees — Jessica Whiddon, receptionist Jessica Anderson, and dental assistant Jennifer Brent — are eligible for limited benefits such as pro-rated vacation, paid time off and holiday pay, but do not receive insurance.
The health board discussed, and later approved in meeting, a two percent increase in dental charges equating to less than one dollar increased cost for most procedures which was requested by clinic dentist Dr. Uchida. The last dental increase, it was noted, occurred more than three years ago.
Under the new rate plan, the base rate for an office visit for observation goes from $70, or $56 under the clinic dental plan, to $72/57.60. A sample of dental services includes $75, $60 under plan, for comprehensive oral exam, $225/$180.80 for application of amalgam on four surfaces, $105/$84 as the base rate for tooth extraction, and $1,134/$907.20 for porcelain/ceramic sub crown.
Business Manager Jessica Whiddon reported that dental patient counts at Lake City Area Medical Center through November, 2017, totaled 761, compared to 658 for January through November, 2016; Physician Assistant Bob Downs tallied a total of 147 patients which he saw at the clinic for the month of November this year, compared to 95 patients in November, 2016; Family Nurse Practitioner consulted with 111 patients last month, compared to 117 in November, 2016, and Dr. Durmon’s tally, November, 2017, compared to November, 2016, was nine patients this year and 65 patients last year.
Cumulative patient numbers at Lake City Area Medical Center for the 11 months January through November, 2017, are 4,048, compared to 4,240 for the comparable time period in 2016, a decrease of 192 patients.
Business Manager Whiddon discussed with health board directors the potential for bringing in as-needed a mobile nurse practitioner from Crawford, Colorado, to ease scheduling on rare occasions when PA Downs and FNP Huisman are unavailable from January through April next year.
Hiring the Crawford NP might constitute a break-even financial basis, according to Whiddon, but would allow the clinic to remain open on an occasional basis when Downs or Huisman have scheduled time off. NP Huisman attended the board workshop and said she was also aware of another traveling Nurse Practitioner who is in the process of relocating from Alamosa to Gunnison.
During their formal meeting, health district directors approved $650 in capital expense allowing Rick Hernandez to build storage shelves in the clinic’s ambulance barn. Hernandez will buy the lumber and volunteer his time to construct the shelves.
The board will meet with computer guru Dan Wampler to discuss a proposal by CenturyLink to install fiber lines for faster, more reliable internet service at the medical center. The upgrade, however, would increase monthly costs from $562 at present to $970 per month.
Board member Janel Warren queried fellow board members on making rooms in Zeller Fitness Center available for practitioners of alternative services, such as acupuncture or massage. Although not affiliated with Lake Fork Health Service District, rooms are available for rent in the fitness center on application.
Currently chiropractor Doug DeShazo and Gunnison-based Heights offer physical therapy on a regular basis. Space in Zeller Fitness Center “stays pretty full,” according to Malinda McDonald, including regular, weekly use by Zumba and Yoga instructors, EMS and EMT training, and occasional meeting space for Lake City Continental Divide Snowmobile Club, Hinsdale Public Health, Hinsdale Veterans’ Service activities and, occasionally, Club 20 and Gunnison County Electric.
Budget-related motions concluded the December 11 health district directors’ meeting, Becky Campbell, as budget preparer, noting “I feel good about the 2018 budget as it is.”
A motion to formally adopt the proposed 2018 budget was made by directors Campbell and Jerry Johnson, and unanimously approved. Also unanimously approved with motions and seconds by Johnson and Schell, and Schell and Warren were resolutions on the health service district’s mill levy and operation budget.
Specifics of the now-approved Lake Fork Health Service District 2018 budget are based on cumulative revenues of $1,006,789.80 and expenses of $976,724.48 plus $10,000 set aside for capital expenditures and $15,000 in contingency expenditures.
$976,724.48 in health district expenses next year compare to $1,087,203.19 projected in 2017, and $1,147,404.24 actual in 2016. Next year’s expenses include $426,576.90 wages (down from projected $495,247.51 this year), $37,700 accounting, $13,700 computer-related costs (projected at $49,347 2017), $12,450 staff education, $71,200 insurance, $15,000 in recruiting expense, $83,950 in supplies (including pharmacy and medications), $19,333 utilities, and $30,030 repair and maintenance.
Income for the health service district is projected at $1,006,789.80 in 2018, principally derived from patient revenues ($560,000), the 1 percent sales tax ($145,000), and Hinsdale County property tax ($311,981).
The 2018 budget starts the year with a $525,133 beginning fund balance and is projected to end the year with a balance of $533,065.
Dental income at the clinic is projected to reach $107,100 next year, with projected expenses totaling $91,270.