For one thing, Powell is now providing pharmacy services at South Big Horn Hospital three days per week through a pharmacy coverage agreement between the two hospitals. Arleen Campeau, PVHC vice president for patient care services, said the contract is similar to one that the Powell hospital has with North Big Horn County Hospital in Lovell.
In addition, Powell Valley Hospital sends an ambulance crew when a South Big Horn patient needs transportation that involves advanced life support, said Campeau. The Powell ambulance crews generally transport South Big Horn patients to Powell Valley Hospital or to hospitals in Billings, she said.
“We’re being called in because currently their (local) ambulance service doesn’t provide advance life support ambulance services,” such as the use of a ventilator during transport, Campeau said. “When John (Adlesich, Chief Executive Director for South Big Horn County Hospital) contacted us several months ago, they didn’t have the ability to transport people by ground, which meant they were sending a lot of people by helicopter, and that gets a little expensive.”
South Big Horn community concerns
Calling for Powell ambulances has caused concern among some Big Horn County residents, who believe the hospital — located between Basin and Greybull — should be using the privately owned Atwood’s Ambulance Service of Basin.
In an email to the Powell Tribune, former South Big Horn County Hospital trustee Bill Burbridge said calling on PVHC “is taking resources away from Park County and Powell because the hospital feels that Atwood’s does not provide the level of care they want. On the other side, our patients, who are suffering from some type of medical crisis, are forced to wait an hour and a half to two hours while they are being transported to another hospital to be treated.”
Burbridge said sending for ambulances from Powell also jeopardizes South Big Horn County Hospital’s standing as a critical access facility when people aren’t getting immediate access to the care they need.
Adlesich, however, said calling for an ambulance from Powell sometimes is the best way to provide the level of care a patient needs.
“We always do what is best for the patient,” he said. “For patient safety, sometimes we will utilize Powell Valley, oftentimes to go to Powell hospital.”
Powell Valley Hospital is able to provide more advanced care than South Big Horn County Hospital can, he said.
Adlesich said Powell Valley Healthcare sends a respiratory therapist on ambulance calls when needed. In addition, PVHC has a license through the Drug Enforcement Administration to carry medications on its ambulances, and a nurse on board to administer them, while Atwood’s Family Ambulance did not.
He noted that Powell Valley Hospital has intensive care facilities with a ventilator, while South Big Horn County Hospital currently does not have that equipment.
“If a patient requires a vent, we still would use Powell Valley,” Adlesich said.
Campeau said a decision about where to transport a South Big Horn patient is made by a medical provider at South Big Horn County Hospital, based on the level of care that patient needs.
“They discuss what they think the patient’s needs are, and make the decision based on the patient’s needs at the time. ... We do take care of ventilated patients (at Powell Valley Hospital), especially if they’re expected to come off easily and rapidly,” she said.
When possible, sending South Big Horn patients to Powell instead of Billings keeps them closer to home, Adlesich said.
Campeau said patients are transported to the closest facility that can provide the appropriate level of care.
“That’s part of the regulations, and we always abide by the regulations,” she said.
The ambulance issue is part of a larger rift between Burbridge, who lost his bid for re-election in November, and Adlesich and other members of the South Big Horn County Hospital Board of Trustees.
A discussion between Burbridge and Board Chairman Jeff Grant became heated during a board meeting last month; it culminated with Burbridge putting his hand near a gun he routinely carries, the Basin Republican-Rustler reported. The Big Horn County Sheriff’s Office was called and a deputy took statements.
Adlesich said South Big Horn County Hospital and Atwood’s Family Ambulance are working together to resolve the problems they’ve experienced.
“We’re committed to working well and utilizing Atwood’s when possible,” he said. “Both of our teams work well together. We value and appreciate everything that Atwood’s does for our community.”
Atwood’s owner Clayton Draggoo declined to comment, but said he believes the situation has been resolved.
Campeau said she heard about concerns in the South Big Horn community over Powell ambulance calls.
“I think they thought we were coming in and taking over,” she said. “That wasn’t the intent at all. The intent was to help out where there was a need.”
Campeau said Powell Valley Healthcare provides ambulance services to South Big Horn County Hospital — and other Big Horn Basin hospitals, including West Park Hospital in Cody and North Big Horn County Hospital in Lovell — through mutual aid agreements.
“If our ambulances are out, or if we don’t have an advance life support team because they’re out on other calls, (West Park ambulance crews) help us out. Likewise, we help other teams in the Basin,” she said.
“It’s amazing how well the community hospitals really work together to provide ambulance service and make sure we cover for each other,” Campeau added. “Sometimes in Cody, two or three ambulances are out on calls, and they have had to call us out to help with a call. It’s amazing; that’s why those mutual aid agreements are really invaluable.”
If Powell Valley Hospital ambulance crews were unavailable for an advance life support call from South Big Horn, the call would go out to West Park Hospital or an air ambulance service instead, Campeau said.
“We’re lucky that we have air flights, with helicopter services around us in Worland, Riverton, Billings and Cody.”