Commissioner Etchegaray and Jake Tibbitts travelled to Fallon on Nov. 9 for a cattlemen permittee meeting on the Navy’s Air base proposed expansion.
Etchegaray attended a Nov. 8 Firemen’s meeting in Crescent Valley; a Search and Rescue Meeting on the 15th as well as the Thanksgiving Dinner at the Senior Center and the Nov. 16 Newmont breakfast in Elko.
Chairman Goicoechea also attended the meeting on the 9th in Fallon and then with on to Carson City after the meeting for a Sage Brush Ecosystem Council meeting on the 10th where necessary changes to and issues with the Conservation Credit System were discussed with recommended changes to be addressed at a January meeting.
Having reviewed a written complaint alleging the existence of a nuisance as defined by NRS 40.140, setting a hearing for 11:15 a.m. Dec. 20 and authorizing the sending of another letter;
Clerk/Treasurer Bev Conley reported Eureka began the month of October with a General Fund Balance of $15,195,344, saw revenue of $1,800,969 and disbursements of $914,714 leaving an ending General Fund Balance of $15,370,600.
A resolution honoring Vera Bauman was read into the Record to applause and a standing ovation and special thanks by Commissioner Etchegaray “for all the good she’s done for Eureka County.”
Medical Clinics Advisory
Garney Damele, Chair of the Medical Clinics Advisory Committee reported that the committee met and went over First Quarter penalties from the quarterly performance audit of Nevada Health Centers and presented a detailed description of what they arrived at which totaled $35,100. Damele said, “A lot of that would be that there was no physician–our physician parted ways with NHC in August” with Laurel Kleinman, APRN, a Nurse Practitioner, covering the clinic. Damele said there “hasn’t been a locum except three days” during the “first quarter and that was on a weekend.” Damele said, “We did discuss our penalties at length and agreed” they “wanted to penalize NHC for no physician.” They had hoped to reconcile with NHC COO, Karl Sundberg, but he wasn’t in attendance and they presented him the letter when he arrived for the Commission meeting.
District Attorney Beutel asked what reconciliation she was referencing.
Damele said that NHC had agreed to $18,600 for the quarter but the Committee recommended the Commission “go for the $20,000 cap on this current contract.” The most the current contract with NHC allows in penalties is $20,000.
Damele said another penalty was added “just this morning of $1500” related to a patient not being able to get an x-ray done; and related the penalties are over $20,000 even if the physician penalties were removed and noted that the Crescent Valley Clinic has been closed quite a bit and the Crescent Valley representative to the MCAC reported “that clinic has only been open one day a week for the past three weeks” and “possibly next week also.”
Kellerman said she spoke to the NHC practice manager in Elko and was told they’re trying “to get us a substitute and there is no one available.” It took Kellerman “three weeks just to get an appointment” and she has “to wait till next week to get in” after making the “appointment a week ago.”
Attorney Beutel asked, “We’re going to wipe out the entire penalty?”
Damele said, “Yes.”
Goicoechea said, “We’ve reviewed this” and asked for a motion to assess the penalty which Commissioner Etchegaray made and the Commission voted all in favor to penalize Nevada Health Centers $20,000 for the first quarter.
Karl Sundberg, COO of Nevada Health Centers and Randy Christensen, CMO, then appeared before the Commission to consider a proposal from Nevada Health Centers to amend the County’s Fiscal Year 2016-17 contract with NHC.
Christensen said he has spent most of his “20 some years in health care in Arizona” and moved to Nevada for the opportunity to be NHC’s chief medical officer and all of his family lives in rural communities, including miners in Elko. He said he’d met “Laurel” whom he described as a “wonderful person” and hopes to “help in getting other people like Laurel.”
Sundberg related that Christensen came from Phoenix Children’s Hospital and has a focus on “how to create the right type of care in each community” and on building care teams. Sundberg related it’s “getting to a point where we have huge competition in getting physicians into these communities,” noting even Las Vegas and Carson City are facing a “huge challenge” with both Elko and Carson City having been short physicians for six months. Sundberg said it is “not something that is easy to recruit in.”
Turning to the loss of Dr. Whitaker in August, Sundberg said he got the news right after the Commission meeting that the doctor wanted to move back to Las Vegas and NHC in trying to fill the Eureka physician spot via a locums company, even the locums company is short and, related to Crescent Valley, Sundberg said they are having “Niki Bain there as much as they “can possibly get her there, one day when she’s available” since she is also under “contract with somebody else.” Sundberg said they “took what we could get in terms of getting someone in Crescent Valley.”
Sundberg said, “As far as the x ray situation” it depends on “what physician’s assistant was on that particular day to understand what was going on with that x-ray” as the practitioner may not have known how to do an x-ray since there is “clear training to be able to do that.”
Sundberg said NHC does have “a physician candidate” but didn’t “know if that person will want to accept an offer to come to Eureka” as well as not knowing whether the candidates’s medical background comes back “clean.”
Sundberg said NHC wants to have an “open dialogue” with the Medical Clinic Advisory Committee addressing what the community needs and setting “it up for long-term sustainability.”
Goicoechea said, “I don’t think something has changed. We want all we can get.” He noted Eureka invests “ a lot of money into this” and said, “Gentlemen, I am extremely disappointed” having “sat here in July and worked it out in good faith.” Goicoechea noted the “huge fines again” and said, “Our constituents expect better. I sympathize that there’s a nation-wide shortage of physicians but you guys are under contract.”
Asked what NHC can provide the county in terms of medical service, Sundberg said they “will get a locums in here as quickly as possible.” Sundberg asked about the possibility of “readdressing getting two mid-levels versus having a physician?”
Goicoechea said they will reevaluate the situation on Dec. 20 and look at “your figures and what you’ve done” and the Commission “may want to renegotiate a contract or put out an RFP [Request for Proposals].”
Mike Sullivan, EMS Coordinator, reported that Crescent Valley’s crew is still understaffed and has had one call they couldn’t answer. EMS Continuing Education will take place, Nov. 28 in Crescent Valley and took place Nov. 17 in Eureka at 7 p.m. Sullivan said the Crescent Valley ambulance has been busy and is worried about “burning that crew out.”
Sullivan said it looks like State EMS is still looking to increase fees over three years rather than all at once and turn EMS into a revenue generating arm.
Oct. 25, the EMS assisted the Sheriff’s Office in a rescue operation up north in which Sheriff’s personnel walked in and found an accident victim who was air-lifted. Carlin VFD provided the ambulance. The rescue required going into the back country through fences. The Nevada EMS Office inspected all the county ambulances and found deficiencies which were corrected at once and no fines were assessed.
Sullivan said data is being transferred into the electronic system which should be a significant time saver.
There is a hybrid class with most work done on line being offered in Austin. A new volunteer has signed up to be a driver.
Sheriff Keith Logan transferred a service vehicle to the EMS and markings are being removed and it will be placed in response in Eureka as a quick response vehicle.
Tom Dunkelman, the On-Scene Coordinator for the US EPA’s ongoing clean-up work in the Town of Eureka, came to review work accomplished in 2016 and plans for 2017. Dunkelman related that from May 1st through the end of September, 20 to 25 people were on crew with three Diamond Valley Sand and Gravel truck drivers who worked through the summer. Dunkelman saw “success in the summer thanks to hard work.” He felt the crew was “respectful interacting with residents” and did “a great job for us.” 39 properties were completed this season for a total of 83 totally cleaned-up in Eureka over the past several seasons. In addition, the repository on Ruby Hill Avenue on county-owned property was completed which Dunkelman called “very helpful” since if they had to haul the dirt away it “would have been prohibitively expensive.” With the repository completed by the end of July, dirt began being hauled in in August with all 20,000 cubic yards of contaminated soil held in 3 temporary repositories collected placed in there.
Dunkelman said the repository has enough capacity moving forward for work next year with space available and “plenty of capacity for dirt” they “might need to put in there.” 70 more properties were sampled bringing the total to almost 300 properties in town sampled to date. Dunkelman said the feedback from the community “is good” with property owners “happy with the quality of the work.”
$9 million has been spent to date making it the most expensive clean-up project in the EPA region’s history. Cleaning up four hillsides and the slag piles and roughly 40 properties a year, could entail three to four years of work assuming $3 to $4 million is budgeted per year. Dunkelman said it’s an “ongoing struggle each year to identify funding and he doesn’t have the full budget for next year. He’ll be meeting with headquarters’ staff whom he’s hoping will “pony up an additional two million dollars.” Dunkelman hasn’t been able to obtain “funding from our headquarters” and said it’s “tough to do long-term planning but that’s where we’re at.”
While Dunkelman has heard “loud and clear this community is not interested in a Super Fund listing,” the EPA headquarters don’t “like to fund sites not on the Super Fund list” and at $3 to $4 million a year for 3 to 5 years it’s getting “harder and harder to find cash in the Region’s check book.”
Ron Damele, Public Works Director, reported all utility systems are “working good.” They are reviewing the fire protection plan which is a “bit different than what seen in the past” although he doesn’t “see anything that will be too big of an issue as they work out how everything dovetails with the State NDF plan since they have to work with NDF “who’s our contractor.”
Nov. 30, Damele will attend the FAA annual entitlement grant meeting in Carson City at which the county capital improvement plan will be considered and critiqued. Damele said the County is well on its way to implementing pavement for the taxiway. Damele reported the draft parcel map for the Catholic cemetery buffer is on the Planning Commission agenda. He and Raymond Hodson have been working on the Public Works budget and having completed 42 percent of the budget year, Damele said most everything is below what was budgeted and sees them as “lucky in that regard” although they haven’t faced snow yet.
Damele and Hodson are going to take a trip to visit with NDOT in Carson City to “work out pavement maintenance ideas for next year” and is “thinking about a county-wide micro-pave to hold some of these roads together from the top until we can get money for total reconstruction.”
In an update on the County’s attempted purchase of the property at 11 North Main Street, the Railroad Car, an offer of $15,000 over a 90 day time frame was made based on an appraisal and a letter was sent to Carol Caton as the property was held by Carol and Cathy Caton. After the initial contact indicating a desire to accept the offer, there was no word and Damele learned that “Carol had passed as well” and the family is working through the estate which still is interested in the County’s offer. The Commission motioned to extend the offer through June 30.
Jake Tibbitts, Natural Resource Manager, said, on Nov. 8 he was invited to participate in a “sit down” with the Nature Conservancy to “talk about some of the water stuff going on.” Tibbitts related that the Nature Conservancy in Nevada hired a hydrologist to work on water, Laurel Saito, a past hydrology professor at UNR. The Nature Conservancy is getting more involved on water and presented a white paper to the Legislative Committee to Study Water and they talked a lot about Diamond Valley.
The Nevada Association to Manage Sage Grouse is consulting with “folks from Utah” who have been “running science through Utah State University” and studies are not matching up with the Federal Agencies as Utah is seeing “great increases of birds based on implementing the Utah plan.”
Tibbitts said at the Federal level there are “still some efforts taking place to try to put at least a short term fix on the federal level to allow states with plans to move forward” but with a lame duck President Tibbitts is not sure how that will play out. Tibbitts is “not very hopeful” they’ll be able to “get these things halted.”
Regarding the County’s scoping comments to submit on the Fallon Range Training Complex (FRTC), Tibbitts said he and Abby Johnson continue “to plod away at flushing out comments on this.” The Navy expanded the scoping comment period to Dec. 12, so Tibbitts will bring the final letter to the Dec. 6 Commission meeting. Tom Young is helping with the comments on the potential impacts to the airport since he’s worked on the improvements there.
Eureka County Commissioners approved:
Expenditures of $490177.52 with Yucca Mountain expenditures of $79.95;
The abstract of the vote and canvass of the returns of the 2016 General Election held Nov. 8, 2016;
Accepting resignations from the Senior Centers Advisory Board;
Appointing Teresa Pittman on the North End to the Senior Centers Advisory Board for the remainder of a three-year term through Dec. 31, 2016 and George Parman for the South End for the remainder of a three-year term through Dec. 31, 2018.