Trustees continue mental health services discussion at board meeting

North Big Horn Hospital District Board of Trustees continued their discussion about the need for mental health services in the community at their most recent meeting held on June 18. Master’s degree student Tyler Drennen joined the meeting for the second month in a row via teleconference. Drennen is pursuing a degree in health administration and is studying the need for these services within the hospital’s service district. 

Trustees peppered Drennen with questions, especially about what information he used to determine the need for this type of service. Trustees were especially interested in how many patients provider Ali Wagner would need to see in a day in order for the hospital to break even on the cost of providing mental health services. Drennen said Wagner would need to see four patients in addition to her regular patients. He noted that there would be no capital investment required in the facility since the services would be offered alongside the regular clinic services using the same facility. 

Drennen again reiterated information he presented at the board’s May meeting, that with a patient population of 6,000, an estimate based on national averages predicts that about 1,200 patients in the community need mental health services. He said the numbers were based on national averages. He estimated that with approximately seven visits per year, per patient, offering mental health services had the potential for 8,400 potential visits per year.

Drennen predicted that though the first year could generate a loss financially, he would predict breakeven status within the fifth year. He noted that this is a very conservative estimate.

According to the plan, Wagner would transition from being mostly a primary care provider to be mostly a mental health provider by the fifth year. He also reminded the board that current studies show a shortage of 2.8 mental health providers in the area.

A clinic report submitted by clinic manager Amber James showed that the clinic had a higher volume of visits (1,234) than its targeted goal of 1,100 visits. The visiting nurse program provided 243 visits and 132 patients were scheduled for a same day visit. 

James reported that the clinic staff continues to work toward improving registration accuracy. The clinic saw an increase in electronic survey data collection. She noted that receptionists continue to improve scores with regard to their goal of being “helpful, courteous and respectful office staff.”

James also reported 35 patients enrolled in chronic care management.

Director of Nursing Michael Henley reported that the hospital admitted 13 inpatients in the month of May, six swing bed patients were admitted and three patients were admitted to recover from surgeries. He said there were no Covid-19 related admissions in the month of May.

In other matters, trustees quickly passed the district’s annual budget at a special budget meeting that was held before they dove into their regular board meeting business. 

CEO Eric Connell commented that the budget would be a test of the abilities of administrators to stay on target with the district’s goals to break even financially.

Since CFO Darcy Robertson gave a preview of the budget the previous month, there was very little discussion before the budget passed. A summary of the proposed budget for the fiscal year ending June 30, 2025, was considered as follows: estimated total cash and revenue requirements for the general fund $26,508,650; total adding in the cost of administration, operations, capital outlay and debt service $32,941,628; mill levy budget $1,143,108. The budget was passed with very slight adjustments.