PureView votes to end partnership with Lewis and Clark County in 2020

The PureView Health Center board of directors voted June 5 to end its 25-year partnership with Lewis and Clark County and strike out on its own as an independent nonprofit in 2020.

The move has been under consideration for more than a year, Lewis and Clark County Commissioner Susan Good Geise said at the June 7 Lincoln Government Day meeting.

The announcement of the decision comes as PureView prepares to apply for the Health Resource Service Administration grant that has provided primary funding for its operations since the organization opened its doors in 1994 as the Cooperative Health Center.

"We're supposed to apply in the fall, and what we're looking at is applying as PureView, rather than as both the county and PureView," Jill Steeley, the executive director at PureView told the BVD.

The Cooperative Health Center got off the ground with a federal grant received through a co-applicant process with Lewis and Clark County which Geise said was a standard practice throughout the country in the 90's.

Although PureView and Lewis and Clark County have been co-applicants on HRSA grants since '94, Steeley said their grantor no longer likes that model.

"They like for the funding to be controlled by the health center board of directors and not the public entity," she said. "It's not due to any negative relationships with the county, it's just simply a business decision."

The separation is slated to go into effect March 1, 2020, the day after the current HRSA grant expires.

Under the co-applicant model, PureView has its own board of directors and manages its clinics, including Parker Medical Center here in Lincoln, but their only direct employee has been the Executive Director. The county serves as the employer for personnel working at PureView facilities and provides the organization with IT and human resource support.

The arrangement provided PureView with stability as it grew, but it also came with drawbacks.

"We tend to move and progress at a more rapid pace than the county," Steeley said. "Just naturally being government, they don't move as quickly and aren't as nimble as we need, because everything is a public process."

That slow, deliberative process impacts everything from contracting to salaries.

"We're not able to provide competitive salaries for some of our positions because we use the county pay grade. Sometimes that can make it difficult to recruit for those positions," she said.

Steeley explained that PureView's future as an independent non-profit could prove beneficial to Lincoln in the long run. It untethers them from the county pay scale, which opens the door for them to offer more competitive salaries to prospective medical service providers. That could improve their odds of attracting a provider for Parker Medical, which has historically had problems with recruiting.

It will also allow them to apply for additional private grants that aren't currently available to them and pursue fundraising efforts, which they're not able to do now, due to the connection to the county.

Both Steeley and the commissioners realize the announcement of PureView's plan to separate from the county, coming as it does on the heels of Nurse Practitioner Laura Broussard's decision to return to Oklahoma, may spin up rumors about the future of Parker Medical Center in Lincoln. However, neither PureView nor the commissioners are foreseeing a change in services for Lincoln.

"We don't' have any plans at this time to close Parker Medical Center," Steeley told the BVD

"We feel like if we are going to separate, it makes our business more sustainable and able to provide more access points in under served areas."

"PureView Health Center is under no legal, contractual obligation to provide services at Parker Medical. That is their belief," Geise said at Friday's meeting. "That being said, they have re-affirmed multiple times it is their intention to continue to provide services at Parker because they know it is important to the community."

Commissioner Andy Hunthausen said PureView's decision isn't unprecedented.

"They're looking at the most efficient way they can provide the service and keep it going," he said. "Cascade county has gone through this process; Yellowstone County has gone through this process.

"They have been studying, along with the county, the best way to provide the services with the least amount of red tape."

Geise pointed out that the best way to ensure continued services at Parker is to make sure people use those services.

PureView's services present something of a Catch 22, however. Zach Muse, Chairman of the Upper Blackfoot Valley Community Council, pointed out that more people would use services at Parker, if more services, such as the clinics unused x-ray, were available.

Likewise, the clinic faces a potential exodus of patients after Broussard leaves, a fact not lost on Geise.

"When you have a provider leave, you take a hit every time, every single time, until the new person comes and builds a repoire with patients," she said

Steeley told the BVD PureView has contracted with a travelling Family Nurse Practitioner who will begin providing services at Parker July 1. She said they will probably contract with that person until they can find a permanent replacement. "We have the position posted with a lot of different organizations, trying to cast a wide net. So far, we don't have any applicants."

Once the separation goes into effect, current county employees working for PureView will become PureView employees, if they choose to, Steeley explained.

"There are still parts of this separation agreement we are working out and we will do our absolute level best to do everything we can to make sure services continue in Lincoln, along the lines of the status quo," Geise said.

The PureView board of directors is planning to hold their September meeting at Hooper Park in Lincoln, which will provide locals with a chance to get more information on the organization's planned separation from the county

"I hope a lot of people will come," Geise said. "They are counting on it." She said of the meeting.