Committee forms to lead process for new medical facility

By Emily Stifler Explorebigsky.com Managing Editor
BIG SKY – More advanced health care services may be on the way for
Big Sky.
A group of representatives from Bozeman Deaconess Health Services
on June 17 presented a new feasibility study for a proposed Big Sky
Medical Center in a public forum at the Big Sky Chapel.
“I have to admit, there are a few of us that would like to back the
bulldozer up tomorrow and start digging a hole out there,” said BDHS
CEO Kevin Pitzer, whose organization has owned land in Town Center
since 2007, and recently negotiated to expand that parcel.
BDHS is a not-for-profit corporation that runs Bozeman Deaconess
Hospital in Bozeman and operates a pharmacy in Big Sky; it has
worked collaboratively with the critical access hospitals in Ennis,
Townshend and Dillon, Pitzer said.
Pitzer and his team laid out a plan for a $21 million, 24-hour
emergency facility staffed by Deaconess employees that would work
hand-in-hand with local primary care physicians. BDHS plans to cover
construction costs and operational expenses before the facility
becomes economically sustainable.
Billings Clinic, the largest health care organization in Montana and part
of the Mayo Clinic Network, also recently completed a feasibility study
for a more advanced medical center in Big Sky. A group from Big Sky
including former hospital administrator Jack Eakman and school board
member Ty Moline in July 2011 reached out to Billings Clinic, which is
why it got involved initially, said Billings Clinic spokesman Jim Duncan.
Billings Clinic representatives presented their feasibility study to a
larger group of stakeholders on June 3 at Buck’s T-4, but will not hold a
public forum until invited, Duncan said. The group from Billings Clinic is
enthusiastic about working with Big Sky, Duncan said, but its approach
has been less assertive.
Billings Clinic manages 10 critical access hospitals in Montana and
northern Wyoming, as well as a number of rural clinics.

Community support and due diligence
Both entities are aware they would need full community support to be
successful.
“We’re not going ahead if we don’t have endorsement and the support
of the community,” Pitzer said to the meeting’s nearly 50 attendees.
And Duncan: “We want to be at the table, work with the community, be
open and honest… to make sure that if we’re part of the equation, that
the proposals we’re recommending are in sync with the Big Sky
community.”
A third group, newly dubbed the Healthcare Direction Committee, has
formed to help the community find its way in this process. Led by cochairs Eakman and Mike Scholz, co-owner of Buck’s T-4 and a resort
tax board member, the committee plans to contract an independent
consultant to review and compare the studies.
Funded by $20,000 in resort tax money through the local social
services nonprofit Women in Action, the independent assessment aims
to find “what is best for Big Sky,” said WIA Executive Director Lisa
Beczkiewicz.
The consultant, Howard Gershon, founding Principal of the Santa Fe based New Heights Group, has more than 35 years as a health care
consultant, according to his website. He specializes in strategic
planning, market research, program development and facility
development, and is someone both hospitals have agreed to work with,
Eakman said.
“Certainly the community is only big enough to have one facility,”
Scholz said in a phone interview. In addition to comparing the two
studies, the consultant will “make sure we understand what services
are reasonable to expect from what the studies say, and also aid us in
making sure we gather the right information and ask the right
questions.”
Other members of the self-appointed committee are Beczkiewicz, Dr.
Jesse Coil, a physician with the Medical Clinic of Big Sky, and Big Sky
Fire Chief Bill Farhat. The group wants to add 10-15 more people to its
ranks and would like volunteers with experience in business, finance
and health care, said Eakman, who has been researching options for
expanding health care in Big Sky for more than three years. “Initially we feel both [hospitals] certainly have similar ideas and plans
for our community,” Scholz said, “but our due diligence is about finding
out the details.”
Gershon told Eakman he will have results ready the week of July 14, at
which point the committee will host a public meeting.
The Q-and-A session following the BDHS presentation quickly morphed
into a public discussion, itself.
“How will the community express its opinion [during this process]?”
asked one person.
“It’s a dilemma,” said another, referring to the fact that Big Sky is
unincorporated and lacks local government. “We don’t have any
elected authority that can make decisions and be responsible.”
John Fountain, a retired physician, stood up to address the community.
“This is an introduction tonight,” he said. “Through Jack, Women in
Action and our consultant, we can now refine our questions. This is
what [they] need to lead us through as we interview our two suitors.”

The proposals
Significant population growth and economic recovery in the Big Sky
area, combined with the possibility for future growth, is what convinced
BDHS that now is the time for a new facility, Pitzer explained.
If approved, BDHS would initially seek hospital licensure for a twostory, five-bed facility, expandable to 10, and eventually seek critical
access hospital designation. A CAH would ultimately allow licensure of
25 beds, as dictated by continued market growth.
It would offer onsite imaging, a CT scanner, ultrasound, mobile MRI
compatibility, 24-7 lab and medical services, and a helicopter pad.
BDHS specialty services like orthopedics and mental health would be
part of an outreach clinic. The facility would add an estimated 30 new
jobs, and Pitzer said if selected, groundbreaking would occur next
spring, with the facility to open in fall 2015.
Duncan didn’t offer such detail on Billings Clinic’s plan, and instead
projected the clinic would begin with an enhanced medical facility with
clinical services, imaging capabilities, certain outpatient surgical
services, and a focus on emergency triage capabilities, or all of the above, plus a critical access hospital. At the June 3 presentation, the
Billings Clinic group indicated it would also fund construction and the
initial years of operation.
“There are so many benefits from each facility,” Eakman said. “Each
has their strengths.”
Regardless of which entity manages or owns a medical facility in Big
Sky, a patient referred to higher care would still consult with his or her
primary care doctor on where to go next. Heart patients, for example,
would go directly to Deaconess, and neurological patients to Billings
Clinic.
What matters, says Dr. Maren Dunn, a primary care physician in Big
Sky, is that this is the only major ski resort area in the country without
a hospital.
“If we want to continue calling ourselves the Biggest Skiing in America
resort town and offer all the amenities, we better offer all the
infrastructure. I consider higher-level medical care basic infrastructure,
just like a fire department or a post office. It’s integral to people living
here and living healthy lives.”
Dr. Dunn, who supports either hospital building a facility in Big Sky, had
a few words of advice:
“This is a tough community to break into because we don’t have a
governing group, so you really have to garner support. In order to do
so, [either hospital] better make themselves open, accessible and
transparent in their plans and reasons for doing it.”