Panhandle Health pitches integrated clinic model; Bonner County commissioners press for county-level data and fiscal note

Panhandle Health’s medical director laid out a plan to expand clinical services across the five‑county district while emphasizing preventive care, individualized treatment and a dual clinic operating model, but Bonner County commissioners said they need more county‑level data and a fiscal note before committing additional tax support.

Dr. Pennock, the district’s medical director and lead of the clinical subcommittee, told the Bonner County Board of Commissioners that the district wants “true preventive care, not just early diagnosis,” and proposed an integrated model combining traditional allopathic care with functional and nutritional approaches. He said the district would start from its existing women’s health clinic and add chronic‑disease prevention and treatment, aiming to measure outcomes through district metrics such as life expectancy, premature-death rates and emergency‑department visit counts.

The proposal includes a two‑track clinic structure: a traditional payer pathway (Medicare, Medicaid, private insurance) and a fee‑for‑service practice that would not bill insurance, while retaining a sliding fee scale for low‑income patients. To reduce staffing costs, Dr. Pennock said the district plans to recruit a preventive chronic‑disease nurse practitioner and consider using the Medical Reserve Corps (MRC) — licensed, often-retired clinicians who would volunteer or serve part‑time. On volunteer coverage, the district reported written assurance from Idaho Risk Management that properly licensed volunteers could be covered under the district’s insurance, though officials said some volunteers might instead be employed part time if needed.

Commissioners pressed for concrete, county‑specific figures. Dr. Pennock reported Bonner County had about 575 unique Panhandle Health patients (roughly 1,200 points of service across the county clinics) and confirmed the Sandpoint clinic has been understaffed. Commissioners said one day per week of clinic service in Bonner County is insufficient and pressed the district to commit to more days; Dr. Pennock said his goal is at least two days a week in Bonner County, contingent on successful recruiting.

Financial concerns were a central theme. Commissioners cited an audit slide showing an average annual clinical services shortfall of about $658,000. Speakers warned that pending Medicaid funding reductions could further reduce reimbursements (a figure of $22,000,000 in broader Medicaid cuts was cited during discussion). Dr. Pennock described operational remedies under review — renegotiating vendor and payer contracts, improving coding and collections, analyzing reimbursements against Medicare benchmarks and targeting programs that run at a loss.

Commissioners requested clearer measures tying the district’s budget to county residents. Multiple commissioners asked Panhandle Health to provide residency‑linked metrics (dollars per resident treated, dollars per encounter, number of visits from Bonner County residents seen inside and outside the county, clinic wait times and projected days of service). The board said it will evaluate future budget requests against that county‑level equity data. The district’s finance committee, represented on the call by board member Glenn Bailey, was identified as the team that will prepare the fiscal note accompanying any formal funding request.

Next steps recorded at the meeting included an MRC outreach meeting and volunteer questionnaire, district queries to identify how many Bonner County residents are seen in out‑of‑county clinics, and a commitment to deliver a formal business plan and budget/fiscal note to the counties (targeted for the May–June budget cycle). No formal vote or funding decision was made at the session.

The meeting closed after commissioners reiterated they support exploring improved access and prevention approaches but will withhold additional funding approval until they receive the requested county‑resident utilization and fiscal data.