Tag Archives: NIHD

City of Bishop Declares May as Healthcare District Month

As the world continues to celebrate healthcare workers, the City of Bishop chose to salute its local healthcare and first responders Monday night with a proclamation naming May as Healthcare District Month.

This is not the first time the City recognized healthcare workers in May. For the past several years, the City set aside May as Healthcare District Month, and May traditionally housed National Hospital Week and National Nurses Week. The arrival of the Coronavirus indeed lent itself to expanding this recognition to include the first responders and county-based public healthcare staff who work alongside Northern Inyo Healthcare District.

Kelli Davis, Interim Chief Executive Officer, told the council that this recognition focuses on all the community heroes, who are working tirelessly through the crisis at hand. “These first four months of 2020 have been very trying, frightening, and devastating throughout the United States and in our small communities through the Eastern Sierra due to the pandemic,” Davis said.

While many of the frontline workers are obviously our physicians and nurses, Davis noted that other often-unsung heroes contribute to the health and well-being of the community during trying times such as this. These include, but are not limited to, firefighters, air ambulance teams, police officers, paramedics, EMTs, hospital and county teams at every level, and many other community workers required to respond to health-related needs and medical emergencies.

“We are very appreciative of the action our City Council is taking in honoring all of these community members,” Davis said. “These workers continue to risk their personal safety to execute their respective duties, day in and day during this crisis. Honoring our healthcare workers and first responders by proclaiming May as Healthcare District Month demonstrates the appreciation and heartfelt thanks for these folks and the work they are doing on the front lines against the pandemic we have been facing for the past few months and will continue to face for some time.”

Before the City Council read the proclamation into the official record, Mayor Laura Smith paused to recognize some of those who contributed to the team effort. Those workers included: Northern Inyo Healthcare District’s Andrea Daniels, Denice Hynd, Dr. Stacey Brown, Jannalyn Lawrence, Krissy Alcala, Amy Stange, Janice Jackson, Genifer Owens, Emily Smith, Tanya DeLeo, and Scott Hooker; along with Symons Ambulance’s Judd Symons; Sierra Life Flight’s Mike Patterson; Bishop Volunteer Fire Chief Joe Dell; Big Pine Fire Chief Damon Carrington; Chalfant Valley Fire Chief Steve Lindeman; and, Inyo County Public Health’s Anna Scott.

“Our community deeply appreciates the work that’s been done and continues to be done within the healthcare district and beyond,” Mayor Smith said.

Northern Inyo Hospital Not Panicking After Five New COVID-19 Cases

Northern Inyo Hospital held a press conference on Thursday, April 16, 2020, in response to the five new confirmed cases of COVID-19 in the county. All cases were confirmed at the hospital, bringing the total amount of victims to seventeen.

Dr. Stacey Brown could not comment on whether or not the cases were all connected, but did say that each patient’s tests were confirmed to be in the same batch of testing kits that were sent to LabCorp in Phoenix, Arizona. “Those five positive cases were in a batch of twelve people that we tested last weekend,” Brown said.

The Rural Health Clinic Director added that he is not overly alarmed by the five cases. It is more likely that the test results were confirmed at the same time and less likely that every person tested came down with the virus at the same time. Brown said, “The new confirmed cases is not diagnostic of a surge, but more of a testing glut. Usually five to eight tests per day is what we send out for lab analysis. With just one data point to look at and five tests confirmed, I can’t say we are in a surge.”

Turnaround time for testing results will be faster than the usual two days it takes to receive coronavirus testing outcomes. The in-house testing has been approved for the hospital to use, which will allow for patients to find out whether or not  they have the virus in approximately an hour. “As of today, we have in-house testing via nasal swab available,” Brown remarked.

Interim Chief Medical Officer, Dr. Will Timbers, added that the healthcare district has also implemented antibody testing, which will let patients know whether or not they have built up immunity to COVID-19. “Antibody testing in-house is available as well. However, we are not entirely sure how accurate it is right now,” Timbers said.

California Governor, Gavin Newsom recently said in a press conference that in order to lessen up on societal restrictions and go back to some semblance of normal life, he would need to see a decrease in hospitalizations and ICU admissions. The governor outlined “the six critical indicatiors” the state would need to see in order to consider modifying the Stay-at-Home guidelines.

When asked whether or not there has been an increase or decrease in hospitalizations locally, Dr. Timbers said there has been a moderate increase of admissions to the hospital, but not enough to warrant alarm. “Volumes have been up marginally, but nothing that is coming at all close to taxing our resources,” Timbers expressed.

It has been well documented that the majority of cases of COVID-19 are considered by the medical community to be mild, with eighty-one percent of patients reporting mild symptoms. However, just because it is deemed to be a mild case, does not mean that many of the individuals who come down with the sickness do not experience tremendous pain and discomfort.

Timbers also spoke about the misconception that many people have when it comes to what the word “mild” means relating to coronavirus. “Mild, severe,  and critical are used to classify illness in the medical community. Eighty-one percent of people who have COVID-19 are determined to be a mild case based on if they have mild viral pneumonia or no pneumonia. Mild cases in the medical community is not what the majority of the public would perceive as a mild,” Timbers remarked.

The Tide May Be Turning In Northern Inyo Hospital’s Favor in Fight Against Coronavirus.

There is finally some good news when it comes to Northern Inyo Hospital’s fight against the coronavirus pandemic.

During Monday’s press conference with Rural Health Clinic Director, Dr. Stacey Brown, the hospital announced that the long-awaited  speedy coronavirus test will be ready for NIHD to use by the end of the week.

Brown said, “We finally got our rapid turnaround testing kits validated. The new testing protocol for coronavirus will take around an hour to complete. We will have this testing up and rolling by the end of the week.”

The rapid testing will mostly be used for critically ill patients and essential healthcare workers.

Dr. Brown also expressed that the hospital is aiming to expand testing capabilities to the general population in the future. The district would essentially move from a “containment” public health strategy, back to a “surveillance” strategy. With a “surveillance” strategy in place, NIHD would resume contact tracing, meaning the hospital would test those who have been in contact with a confirmed COVID-19 victim.

However, the hospital does not plan to test random individuals from the general public. The idea of doing so is simply unrealistic, since Dr. Brown said the hospital has roughly 200 testing kits available.

Brown added, “It would be an epidemiologist’s dream to test everyone in the town, but we don’t have the capacity to do that right now.”

Even better news than the rapid testing, is the notion that there is finally an end in sight when it comes to lessening social distancing measures and reintegrating various parts of society back in to the picture. As Interim Chief Medical Officer, Dr. Will Timbers remarked, “The rational here [when it comes to opening services] is that even if we do see a surge of COVID-19 patients, it is unrealistic that this disease is going to go away after we have one big surge. It will likely be a slow burn for cases, but we have to get some people back to some semblance of normal life. To that end, over the next several weeks, the hospital will provide a wider scope of services. This is going to be more like a marathon opposed to a sprint.”

When it comes to an actual timeline of when some societal functions will return to normal, Inyo County Public Health Officer, Dr. James Richardson, recently said he expects social distancing measures to lessen around May. “I suspect around mid to late May, things will start to lighten up. However, there may be a undercurrent of this virus in our community for a while,” Richardson said at last week’s “Inyo County Virtual Town Hall Meeting.”

Dr. Brown shares similar sentiments when it comes to an expiration date on the intense measures currently being taken. “I would hope that we could start some sort of phased return to normalcy by sometime in May. I will put a caveat on that though. We will be following guidelines from state and the feds before we start to open up.  All kinds of functions of society must be carefully considered, and it has to be a staged and phased rollout to ensure that we don’t have to lock down everyone for another fourteen days.”

 

Coronavirus Testing Results Coming Back Faster for Northern Inyo Hospital

Northern Inyo Hospital gave their weekly COVID-19 update to members of the media on Monday, April 6, 2020.

Dr. Stacey Brown told the media that the hospital is currently functioning at full capacity. “NIH is fully functional for all services at this time. If you break your leg, we are here to treat that,” Brown expressed.

Interim Chief Medical Officer, Will Timbers, shifted the discussion to COVID testing protocols at the hospital. He highlighted false negative tests, which are tests where a patient appears to not have coronavirus, but ends up actually having it. “No test that we do is going to be 100% perfect. We need to make sure to get a really good nasal swab to ensure that we can find out if they have it or not. There are false negatives, where the tests aren’t completely reliable due to limitations in the testing,” Timbers remarked.

Brown added that testing kits will continue to be reserved for essential workers and those with pre-existing conditions. The Rural Health Director said, “The priorities for testing will be for critical staff and critically ill patients. We know the spread of COVID-19 is communicable, so there is no need to test the general public.”

The amount of time it takes for Northern Inyo Hospital to obtain COVID-19 results is becoming more efficient as each week passes. Brown told the media that the hospital is now getting results back in about a day and a half. “Turnaround testing via LabCorp takes about 1.5 days now. LabCorp in Phoenix is doing a really nice job of getting the results to us,” he remarked. When NIHD started testing last month, the turnaround time for lab results was taking anywhere between 7-10 days.

Patients can expect even faster coronavirus testing in the future. The hospital is about one to two weeks away from rolling out their in-house testing, which will take about an hour. “In-house testing is about a week or two off at this point. We are hoping to do in-house testing by the end of the month,” said Brown.

Whether to wear facial covering or not to reduce the spread of coronavirus has been a hot topic of discussion throughout the world, with the CDC now recommending that the general public wear masks after previously discouraging the public from using them. Dr. Brown is encouraging the general public to cover-up. “The CDC came down with recommendations for decreasing transmission in the community by wearing masks. The push on that is to have you protect the rest of the community from spewing out the virus from your mouth. It looks like many people are transmitting coronavirus without showing symptoms, so it is smart to wear masks. My anticipation is that you are going to see the adoption of the masks in our community,” Brown expressed.

The Rural Health Director stated that the community has been stepping up as far as helping out with medical supplies. One such program that Brown says has been quite successful is “project cover-up,” a grassroots effort in which local seamstresses and quilters have created masks for healthcare workers to use. “’Project Cover-Up’ has been a great example of the community stepping up during the pandemic,” Brown said. “So far, we have had over 200 masks donated.”

Dr. Brown is encouraging people to continue to donate medical supplies. “If people are interested in dropping off Personal Protective Equipment donations, you can drop them off at the front of the hospital.”

The Interim Chief Medical Officer, Will Timbers spoke about the possibility of people building up immunity to coronavirus, and if the data he has been examining is accurate, it is a promising sign. “It does seem like with the majority of patients who have COVID, that there is some herd immunity at this point. The data suggests that there are some antibodies that are being built up in patients,” Timbers said.

Antibody testing to see if patients with COVID-19 are building immunity to the virus will be implemented in medical facilities across the world soon. As for testing locally, the public can expect it to be ready some time around May. Dr. Brown said, “Larry Weber, our Director of Diagnostic Services, says there is a rush for antibody testing to be implemented by many companies. Larry and his team have vetted a company that has a good reputation, and that looks very promising. I still don’t see testing happening for a few weeks though. Right now, we are looking at early May.”

Teamwork and Preparation Most Important in NIHD’s Response to COVID-19

It is an overused analogy, the war against novel coronavirus, but as any employee at Northern Inyo Healthcare District will tell you, the battle is real. Ironically, it is a battle most have prepared for throughout their respective careers.

“Every team member brings something to the fight,” says Dr. Stacey Brown, Medical Director of NIHD’s Rural Health Clinic and current Vice Chief of Staff. “Every department plays a role.”

For NIHD Board President Jean Turner, the show of teamwork fits right into the District’s operational design. “When I came onto the Board, I was told our basic structure is that of an inverted pyramid,”
Turner says. “Leadership at the bottom, the workforce at the top. The top is where the real work goes on; it’s where things really matter. If I wanted our community to remember one thing at this point in time, it’s this: Our staff is disciplined, well-trained, and ready for this challenge.”

The District’s fight against coronavirus began in mid-January. For weeks, Infection Preventionist Robin Christensen, RN BSN HIC, kept an eye on what was transpiring in China. On January 28, she called the first team meeting to talk about coronavirus and its potential impact on NIHD and the community. Everyone in the room knew the odds, had watched the numbers coming in from China.

“It is safe to say we wished for the best, but as healthcare workers, we always prepare for the worst,” Christensen says. “It’s who we are; it’s what we do; it is what the community expects from us at a time like this.”’

As the NIHD team developed needed plans, they carried on with providing day-to-day care. Hallway conversations and internal emails began to refer to coronavirus more frequently. The District conducted a pandemic disaster drill on February 13. The tipping point came March 6 when a two-hour coronavirus meeting gave way to a day-long review of staffing levels, supplies, policies, plans, and shared concerns.

The group met the next afternoon again for several hours. They got a late start, beginning at noon. It gave those who volunteered to help at the Eastern Sierra Cancer Alliance’s Blue Ribbon Walk & Run a chance to meet their commitment. For many at NIHD, it was the last “normal” day of the month.

NIHD initiated an internal Incident Command on March 10 and continues working under it today. Incident Commands use a standardized approach to direct, control, and coordinate emergency response. More importantly, it brings people together to reach a common goal.

Like her co-workers, this was not the first time Allison Partridge, RN MSN, worked under an Incident Command. Partridge, the Director of Nursing for the Emergency and Medical-Surgical departments, knows the system well and aids Chief Nursing Officer Tracy Aspel in keeping the daily meetings on task.

Partridge now spends much of her days working with others to put together workflows for the departments that will be most affected. With guidance from Infection Preventionist Christensen, Partridge
and others closely watch the Centers for Disease Control and Prevention and the California Public Health Department for direction. No area or service escaped review.

“We track daily our current availability of Personal Protective Equipment (PPE), and the recommendations for use,” Partridge says. “Additionally, we have made modifications in how we provide services and how visitors access the campus. All of these measures are in place to protect our teams and community. We encourage all employees to adhere both while at work and at home to the recommendations issued by national, state, and local government.”

Carefully crafted plans address the care of Patients Under Investigation (PUIs). Partridge says the standardized workflows are based on the patient’s level of care, whether that be critical care at the hospital or self-isolation at home. Care of multiple positive COVID-19 patients within the hospital remains an area of concern for the small 25-bed hospital.

“A great amount of planning and preparation has gone into every action, and it’s still ongoing,” Partridge says. She notes that just this week, the team was searching every square inch of the facility for places to place more beds. No space is overlooked. An unused and unfinished room located in the two-story hospital was turned into a four-bed safe patient care area within hours.

As for staffing, the level is adequate at this time. The District is working closely with the American Federation of State, County, and Municipal Employees Union on staffing plans should the virus take hold of the community.

As non-essential services are scaled back, staff in those areas become available for use in others. Nurses and caregivers were surveyed to see if they would be OK to serve in other departments they were cross-trained to work in. Recently retired nurses may be considered for voluntary return to bolster staffing numbers. The dedicated care given by generations of NIHD nurses is legendary in the community.

They were also asked who would be willing to work with critical coronavirus cases. No one will be asked to step into a situation they are uncomfortable with — and to date, no one has opted out.

As for the physicians, Dr. Brown and Dr. William Timbers, NIHD’s Chief of Staff, are relying on the aid and advice of many of the District’s Medical Chiefs – Dr. Richard Meredick (Orthopedics), Dr. Charlotte Helvie (Pediatrics), Dr. Sierra Bourne (Emergency), and others. The Medical Support Staff office issued emergency credentials for other physicians in the area should their aid be required at bedsides.

The Rural Health Clinic team launched drive-in coronavirus testing well before some larger, urban hospitals did. The move was based on when the RHC offered drive-in flu shots more than a decade ago.
“Hometown health care can work anywhere, even in the big city,” Dr. Brown smiles.

Dr. Brown’s reliance on RHC Directors Paul Connolly and Jannalyn Lawrence, RN, is evident. Both work closely with the District’s outpatient clinics and played critical roles in clearing barriers for drive-in testing. When offered kudos for the work, Lawrence scoffed. “One Team, One Goal,” she says, incurring the closing line of the District’s mission statement.

Later, as Director of Nursing Partridge studies the endless worklists that paper the walls of Incident Command, she agreed with Lawrence. “Teamwork has played a huge role in managing every aspect of this situation,” she says. “This collaboration has taken place across all disciplines and has included a multiagency approach across Inyo and Mono counties. This great work truly exemplifies our mission of ‘One Team, One Goal, Your Health.’”

Meanwhile, as another day ends for the District team, Infection Preventionist Christensen is in her office. It is quiet in the usually bustling hallway; the result of the District’s temporary telework plan. Almost 80 employees are working from home, practicing social distancing.

Laying across Christensen’s desk are signs of a community lending its support to its healthcare workers: Packages of the valued N95 masks recovered from businesses and home garages, plus several handcrafted face masks. The handcrafted masks, with bright patterns of cacti, cats, and paisley, are especially touching
to Christensen.

NIHD is looking into options that could allow the homemade masks to be used as covers for approved personal protective equipment. That would occur if, and only if, NIHD’s supply of approved masks is
depleted. The covers would help keep the N95 masks free of transferred hand oils, possibly extending the life of the N95s.

“One team,” Christensen says, circling her index finger, gesturing from east to west, north to south. “It’s all of us in the community. Together, we will get through this.”

NIHD BIlling Office Temporarily Closed to the Public

Per Governor Newsom’s Declaration, Northern Inyo Healthcare District announces that due to the COVID-19 virus, the NIHD Billing Office, which accepts payments from the public, will temporarily close to patients. The office will remain open to receive telephone calls for billing questions and payments. Hours are Monday through Friday, 8:30 a.m. to 4 p.m. The direct telephone number is (760) 873-2190.

Payments may also be made by:

  • Mail: NIHD, Credit and Billing Office, 150 Pioneer Lane, Bishop, CA 93514,
  • Telephone: (760) 873-2190, or,
  • NIHD’s website: www.nih.org

Correspondence and Documents may be sent one of two ways:

  • Mail:NIHD, Credit and Billing Office, 150 Pioneer Lane, Bishop, CA 93514, or
  • Email:credit.billing@nih.org

These measures are to keep you, our customers, as well as our employees, at minimal exposure to the virus by social distancing. Stay home, be safe.

Coronavirus Arrives in Inyo County

Inyo County has its first confirmed COVID-19 case.

The first Coronavirus patient has been identified as a 42-year old female living in Bishop. According to Northern Inyo Hospital Rural Health Director, Stacey Brown, the patient came down with symptoms including a fever, cough, chills, body aches, headaches, and low-grade fever.

Health officials instructed the female victim to self-quarantine at her house.

When asked about the status of the patient, Dr. Stacey Brown said he was unsure about the health status of the individual. “I don’t know, but I will reach out to her. As far as I know, she is recuperating at home.”

Brown emphasized that just because a person does not have severe symptoms, does not mean there is no cause for concern.  “This is a great example of how COVID can appear pretty mild in a person. She got tested for a flu and that came back negative. Then she tested positive for COVID, and we got results after a four-day turnaround. The spread [of coronavirus] can present itself in many ways.”

So far, NIHD has conducted fifty-five total tests. Out of those tests, twenty-two are negative, while thirty-two are pending.

The Hospital’s Drive-In testing center was where the patient tested positive for the virus. “The drive-in testing clinic that the district put together was successful in finding our first case in a safe manner,” Brown expressed.

Dr. Brown said the staff responsible for testing the female took all proper measures to minimize the risk of contracting novel coronavirus. “I am really proud of what we have done as far as collecting specimens in a safe manner,” said the Rural Health Clinic Director.

The district will be switching from a surveillance strategy into a containment plan. With containment as the top priority, Brown expressed that the way the hospital goes about testing for coronavirus will be different.

“The testing we do for COVID is going to be focused more on healthcare members so we can get staff back into duty quickly. Testing will also be for acute patients, correctional facilities, and long-term care centers like the Bishop Care Center. We are testing right now, but not for the general public.” Dr. Brown stated.

Director Brown encouraged the public to practice the same strategies health officials have emphasized since the start of this pandemic. Nothing has changed when it comes to combating coronavirus. “Now that we know it is here, it is much more about containing the illness and talking about things like social distancing, hand washing, cleaning surfaces, etc. There is nothing new we have on the horizon from a public health perspective just because it is here.” Brown said.

Coronavirus is Here. How is Northern Inyo Hospital Dealing With it?

NIHD Rural Health Director, Dr. Stacey Brown provided the latest update on COVID-19 in Bishop during a conference call Monday afternoon.

Coronavirus already has a presence in the Eastern Sierra, with a confirmed case occurring in Mammoth Lakes this past weekend. Brown expects a case in Inyo County soon.

“Inyo county does still not have a positive test. In the district, we have done a total of thirty-four tests, eighteen are negative and the balance is pending.” Brown remarked. “For any positive cases that happen in Inyo County, the district will be jointly announcing those with the Inyo County Public Health Department. So as soon as we do have a positive case, which I do expect at some point, those will be reported as a joint effort.”

The RHC Director says both the hospital and county have COVID-19 test kits still available. “We still have availability of testing COVID out in the community, as well as the hospital. However, they are not available for the general public right now. Patients have to be screened and will be tested if it looks like a positive test will be indicated.” Brown said to media members.

Though it is still a positive that testing is available in the community, the wait time to confirm a positive case of coronavirus takes quite some time.

“The difficulty is that the tests that both NIH and Mammoth Hospital are sending out are still sent to LabCorp. The turnaround time on average is 4.7 days [to receive a result] and some of them are still pending seven days out.”

The long wait time for tests results is definitely not a good thing. However, Northern Inyo Hospital fortuitously has a high-tech machine from molecular diagnostics company, Cepheid Inc. The machine, known as the “Xpert Xpress SARS-CoV-2 test” could allow testing results to be provided in as little as forty-five minutes.

“Luckily the hospital lab has a state-of-the-art machine that has the capacity to do rapid testing. This past Wednesday, the FDA authorized Cepheid to go ahead and release the bedside coronavirus testing.” Dr. Brown said. “We are working diligently to get less than an hour bedside testing locally. It may take a little bit of time to get the tests set up, but the hospital may have the ability to get testing out locally that will take about 45 minutes, which would be huge for the district.”

Don’t expect the rapid testing to be available to the general public. Dr. Brown emphasized that tests are for symptomatic individuals along with medical personnel.  “The tests are really supposed to be used for in patient, emergency room patients or if you are trying to clear a healthcare worker to try and work again after dealing with a COVID patient.”

NIHD is taking a new proactive measure when it comes to implementing new ways to see patients. Telemedicine will soon be available for patients to receive primary care.

“A lot of places have been toying with telemedicine for a while to see if it fits the mode in their community. We have been considering it for our district as well. To roll this out in a primary care fashion or triage fashion is something we want to do. Since people are at home, it makes sense to try and reach them from home. “

Social distancing is also an important step that needs to be taken to “flatten the curve.” The action will also help save lives and resources.

Brown says, “I want to stress to the public that this ‘Stay Home’ order from the governor and bolstered by our local health officials is really critical to the success of us making it through this COVID pandemic intact. Folks that are staying home are able to flatten that curve and allow the limited number of healthcare resources to reach the people without being overloaded.”

With that being emphasized, some people are doing a great job at social distancing, while others are not.

“I am super happy to see the public pretty much following those guidelines to go out for essentials only like gas, medical, and grocery.” Brown stated. “However, I am not surprised, but unhappy about folks that are enjoying their spring breaks in beaches and crowded environments. Remember, being young doesn’t mean you’re invincible.”

Chair of NIHD Board of Directors Issues Statement on CEO Suspension

Chair of the Northern Inyo Healthcare District’s Board of Directors, Jean Turner issued a statement on CEO, Kevin Flanigan being put on paid leave for alleged financial and operational issues.

“Northern Inyo Healthcare District placed its Chief Executive Officer on paid leave, pending an investigation of financial and operational issues. Dr. Kevin Flanigan was notified of this change in status on Thursday evening following a special Board of Directors meeting.

Effective immediately, Chief Operations Officer Kelli Davis will serve as Interim Chief Executive Officer.

NIHD will be contracting with a consultant to conduct a review of the issues of concern. The expectation is this may take several weeks or more.

Decisions like this are never easy, and the Board did not take this action lightly. We are aware of the impacts these actions have on the lives of those involved, and we encourage you to be supportive of your colleagues during this time of transition. We appreciate any questions and concerns you may have. We ask you to be patient with the process and understand that we may not be able to answer specific questions due to the status of the investigation.

I have a high level of confidence in this staff and have faith in our ability to weather this challenge as well. I look forward to continuing to work with everyone.

On behalf of the Board of Directors, I thank you for your ongoing commitment to the District’s mission to improving our communities, one life at a time. Together, we have achieved so much, and it is my deepest hope that we will continue to do so.”

NIHD Prepares for Walk with a Doc Event

The next Walk with a Doc event, sponsored by the Northern Inyo Healthcare District, is set for Sunday, Dec. 22nd from 1:30 to 2:30 p.m. Walkers of all ages are invited to gather in front of the Rehabilitation Services Building in the Pioneer Lane parking lot on the Northern Inyo Healthcare District campus.

Dr. David Pomeranz, an emergency care provider at NIHD, will lead the 1.2-mile walk in the nearby Bishop Paiute Tribe’s Conservation Open Space Area (COSA). The walking path in the COSA is a dirt path

Participation is free and pre-registration is not required. Walkers will enjoy friendly conversation with Dr. Pomeranz, who will provide support and answer questions during the walk.
All walks are open to the community, so feel free to bring friends and family. Please wear comfortable walking shoes and bring a water bottle.

All walks are held monthly, please watch media for dates and times. For more information, call Barbara Laughon, NIHD Strategic Communications Specialist, at 760-873-5811 ext. 3415.
Walk with a Doc is a national non-profit organization whose mission is to encourage healthy physical activity in people of all ages and reverse the consequences of a sedentary lifestyle in order to improve the health and well-being of the country.

State Representatives Recognize NIHD’s District of Year Designation

Inyo County’s representatives, State Senator Andreas Borgeas and Assemblyman Devon Mathis, recently recognized Northern Inyo Healthcare District for its designation as the Healthcare District of the Year by the Association of California Healthcare Districts.

Mathis, representing California’s 26th Assembly District, visited the District to present the NIHD Board of Directors and Chief Executive Officer Kevin S. Flanigan, MD MBA, with a framed Assembly Resolution. Borgeas, representing California’s 8th Senate District, had an approved State Senate Certificate delivered by Field Representative Dana Jorgensen.

In October, Northern Inyo Healthcare District’s success with its Medication-Assisted Treatment (MAT) program garnered the District top honors from the Association of California Healthcare Districts (ACHD) as it named NIHD California’s Healthcare District of the Year for 2019.

Earlier this year, NIHD began a MAT program with grant and other funding, which the District runs in collaboration with other stakeholders for coordination of care. During the preceding three years, the District and others began to review opioid use. They identified a trend in the escalation of overdoses, deaths, criminal cases, and medical issues associated with opioid use, misuse, and abuse.

NIHD applied for and was one of 31 named recipients for the Bridge Grant. This action allowed for the creation of the MAT program, which is now expanding into other areas of Behavioral Health treatment. Since the implementation of the program:

NIHD has seen more than 92 enrolled patients in eleven months.

Every NIHD Emergency Department physician has earned special certification to prescribe the highly controlled anti-addiction medication; and,

 More than a half dozen patients have been treated with the life-saving medication, Narcan, by police, first responders, or private citizens outside of the hospital.

State Health officials have also asked the program’s coordinators to share their path of success and growing expertise with other healthcare agencies in hopes of launching similar programs in other areas of California.

Senator Borgeas’ certificate noted that the District’s MAT program has “broken barriers to treat patients dealing with behavioral health issues and is improving their quality of life.” It goes on to commend the entire NIHD staff for the program’s “creative efforts (that) will truly save lives.”

Assemblyman Mathis’ resolution, read into the Assembly’s official record on Nov. 14, made note of the “vital and interdependent” relationship between communities and their nonprofit health care organizations, the resulting positive health outcomes, and “the spirit of ongoing community engagement” fostered through charitable activities.

Mathis’ resolution goes on to note that in keeping with the District’s vision, “NIHD has stood firm to its core value of compassion and integrity; aspirational values of quality, excellence, and innovation, and permissive values of safety and team-based partnerships with its professional staff.” Mathis then went on to congratulate the District as ACHD’s Healthcare District of the Year and commended the Board of Trustees, leadership, and staff for continually providing outstanding healthcare services to the residents of Northern Inyo County.

Revenue Shortfall Pushes NIHD Reorganization

Northern Inyo Healthcare District is undergoing staff reorganization as the direct result of a shortfall against projected revenues in its 2018-2019 budget. The three-phase restructuring began Friday, Jan. 18.

District leadership, faced with a $1.2 million shortfall against its projected revenues, felt it was necessary to make milder adjustments now rather than be faced with more drastic changes in next year’s budget.

Chief Executive Officer Kevin S. Flanigan, MD MBA, stressed the District is early enough in its projections that small changes can have a big long-term impact. “If the District waits until the next budget year, the District will have to both make up for this year’s deficit and cut to prevent another deficit year,” he said.

Dr. Flanigan also stressed that deficit is against budget projections and is not currently a situation in which current expenses are exceeding current revenue. He noted, however, that if something is not done now, this could very quickly become a matter where revenue does not cover costs.

The reorganization calls for a hiring freeze for all non-clinical positions, a re-alignment of responsibilities among these departments, a reduction in non-clinical workforce, and the potential for an offer of early retirement where possible. These changes, to be clear, do not affect any health care providers or clinical staff. These changes affect support staff in administrative areas.

This move does not mean the District is in financial trouble from a cash-on-hand basis,” Dr. Flanigan said. “We currently can pay our bills, and our expenses are matching what we budgeted. However, we are experiencing fewer surgeries and fewer hospitalizations than we projected.”

A reduction in hospitalizations was anticipated, just not to the degree NIHD experienced in the first six months of its fiscal year.

As people will recall, the District was moving toward a care model that emphasized improved health rather than critical illness,” Dr. Flanigan said. “We’ve seen an increase in our outpatient clinic visits. Our Emergency Department visits are consistent with budgeted numbers even with the addition of our Same Day Care services. Our transfers out of the area are only up slightly while our surgeries and hospital stays are down markedly. This means that the improved outpatient access and our focus on improved service have kept people healthier; thus less likely to need surgery and less likely to have to stay overnight in the hospital. However, this also means that the District is receiving less revenue.”

Dr. Flanigan said District leadership has met with staff members during the past few days outlining in detail the current situation, including plans for moving forward. As always, Dr. Flanigan maintains an open-door to those staff who may wish to meet with him privately.