NIHD Board passes 2018-19 budget, hears of service expansion plans

Two years ago the Northern Inyo Healthcare District Board of Directors committed to a five-year strategic plan designed to grow local medical services and improve healthcare access for area residents. As the District prepares to enter its pivotal third year, the investments made in the plan are beginning to shape the future of healthcare in Northern Inyo County.

Last Wednesday night, the NIHD Board of Directors approved the District’s proposed $80 million operating budget for fiscal year 2018-2019. While calling for a four percent price increase for all services except Diagnostic Imaging, the budget is a tight, well-balanced plan that shows a projected net income of just .7 percent net margin, or roughly $600,000.

The budget demonstrates NIHD’s focus on quality patient experiences, improved workforce experiences, and the District’s team-approach to quality improvement and better safety for all.

Following the vote, NIHD Chief Executive Officer Kevin S. Flanigan, MD MBA, noted that arriving at the proposed budget took a comprehensive team-based approach with all leaders focusing on what was best for the District as a whole and not just their departments.

Before the vote, NIHD’s Chief Financial Officer John Tremble guided the Board of Directors through a lengthy overview of what the budget means for the coming year.

In the area of service expansion, the District plans to take the popular Same Day Care from three days a week to six days, better serving those needing acute care. The District also will add two physicians. Family Medicine physician Tom Boo’s return to the Rural Health Clinic comes at a time when the facility expects to see 40,000 patient visits in one year. Internist and Geriatric physician Anne Wakamiya will join the Internal Medicine Clinic, bringing relief to staff following the retirement of Dr. James Engelsby.

The RHC also will expand its Telehealth partnership with Adventist Health by adding four additional specialties to the current offerings of Cardiology, Endocrinology, Rheumatology, and Dermatology.

As for the recently re-established Urology office, the District plans to double the average number of days the physicians are available on campus, from four days per month to eight. Also, requests for support staff for these physicians and services will be approved as long as economics and patient demand allow.

With continued demand for Rehabilitation Services, the District also intends to recruit two additional Physical Therapists, an Occupational Therapist, and two Speech-Language Therapists.

NIHD reaffirmed its commitment to the communities it serves by continuing to offer prompt pay and district resident discounts. Last year these discounts accounted for just shy of $600,000 in savings to patients who choose to use District services. From year to year, that amount often equals or surpasses the amount of tax monies collected from the property taxes of District residents.

Tremble noted that even with the four percent price increase, NIHD’s Average Daily Inpatient charge remains less that State of California’s average and 50 percent less than some of the District’s local competitors.

While almost 70 percent of the budget covers salaries and benefits for the District’s nearly 450 employees, Tremble said the budget reflects NIHD’s continued commitment to current and past employees as evidenced by the District making catch-up payments on the Defined Benefit Retirement Plan. The move leaves less to chance in financial market fluctuations and offers vested employees an improved sense of security.

CFO Tremble also said the District is moving closer to its strategic goal of Outpatient Services providing 80 percent of its revenues. This move aligns NIHD with industry standards and provides better long-term financial stability. When asked where the District was in that transition, CFO Tremble reported that as the 2017-2018 fiscal year ends, the District is just shy of hitting the 70 percent mark.

In an interview Friday, Dr. Flanigan said he was very impressed with the Board’s to-the-point questions regarding the budget, and how they applied their recently adopted District Values and Mission Statement during their deliberations. “With the Board’s commitment, fund of knowledge, and expertise, I have no doubt the District will be well served by them, and our leadership team will have the resources necessary to achieve the Board’s Strategic Goals,” he said.