Survey: Mental health, substance abuse, diabetes leading health concerns in BHC

ALSO: Three Rivers Health begins master planning discussions

A recent countywide needs assessment identified mental health, substance abuse and diabetes as the top three health care concerns in Big Horn County.

Kelsey Sullivan, director of clinic and ancillary services at Three Rivers Health, told the board of directors Wednesday night that the findings did not come as a surprise, as mental health has been cited as a concern in past surveys.

The needs assessment was a collaboration of Three Rivers Health and North Big Horn Hospital. Four-hundred eighteen people participated, with 48% of the responses coming from south Big Horn County, 27% from north Big Horn County and the rest from Park, Washakie and Fremont counties.

“One important takeaway ... is that several of the community’s concerns can be addressed through services we have in place, but we also know we can always do better in improving access to that care,” Sullivan said.

“As we finalize our plan, we expect our next steps to include stronger public education and thoughtful consideration of new or expanded service lines to meet Big Horn County’s needs.”

Sullivan said the needs assessment committee has met twice to discuss the survey results.  When their report is finalized, it’ll be presented to the board for approval. Sullivan said that could come in January.

Audits

Rachel Kettenburg, of Wipfli, presented the findings of the audit for the fiscal year that ended June 30, 2024.  She called it an “unmodified or clean” audit, which is good news for the district. 

According to Kettenburg, Three Rivers Health’s net position increased by $87,000.  Net patient service revenues and non-operating revenue went up while operational expenses went down.

Kettenburg said TRH has been in catch-up mode when it comes to audits. With FY24 now complete, she anticipates getting started soon on FY25.

“(Finance department manager) Michael (Garza) has done a fantastic job getting things caught up,” Kettenburg said, adding, “Kudos to him ... it’s been a heavy lift.”

Master planning

With its financial situation stabilized, the TRH board has begun discussing concepts of a master plan update, with Fred Werner and Trudy Craft at the forefront of that steering committee.

Both remarked about how the preliminary concept eliminates a lot of unused space and improves traffic flow.  

All but 4,000 square feet of what is now the old nursing home wing would be eliminated and the footprint of the building would be considerably smaller, to the point it could be served by a single HVAC system.

The concept plan envisions the front door of the clinic being on the northeast side of the facility.  Patients would be able to walk right into the clinic; right now, they enter through a door on the west side that’s used to access the hospital and emergency room.

CEO Joel Jackson said a board work session to discuss the concept plan will be planned in a few months, when he hopes to have more clarity from the federal government and a better sense of what the project would cost and how to fund it.

In other business:

• The monthly financial report showed a net operational loss of about $22,000.  Compared to October 2024, the district showed a slight uptick in patient encounters (1,469) and days of cash on hand (75) last month while its days payable outstanding (35.06) and gross accounts receivable days (66.6) both fell.

Average daily revenue was $53,425 last month, $43,865 in October 2024.

• Sullivan said last month was the best one on record for its mobile MRI service, with 21 taking place.  The mobile MRI units makes weekly stops at TRH, always on Thursdays and in the morning.

“In the first year we had that service here, we did 127 procedures — that means 127 times, a person didn’t have to take a half day off work, drive 100 miles and sometimes in mid-winter,” Jackson said. “They could come here. We anticipate that service will grow significantly in the next year.”

• Tamara Sawyer, director of human resources, compliance and risk, said the enrollment period had opened for employees to sign up for health insurance through TRH.  

As an organization, TRH is facing a 19% increase in costs.  The leadership team decided to absorb the increase, rather than asking its employees to bear the additional burden.