BOCC reviews health district’s clinical services

By Soncirey Mitchell
Reader Staff

The Bonner County Board of Commissioners met Jan. 14 for a special meeting with representatives of the Panhandle Health District to discuss a recent audit of the organization’s clinical services. The analysis, conducted by Medical Director Gregory Pennock over a period of four months, examined the clinics’ average expenditures, profits, procedures and patient demographics to better understand how to cater to local needs going forward.

PHD hosts clinics five days a week in Hayden, once a week in Sandpoint and once a week divided between Kellogg and Saint Maries, providing immunizations, sexually transmitted infection tracking, family planning, cancer screenings, mental health referrals and most anything else required of a primary care provider for residents of Idaho’s five northern counties. According to Pennock, the clinics account for approximately 18% of PHD’s total budget but generate approximately 10% of its revenue. 

In Fiscal Year 2025, the district received $2,496,906 from Benewah, Bonner, Boundary, Kootenai and Shoshone counties combined, of which $661,123 went to clinical services. Of that, Bonner County contributed $513,798 — $136,041 of which went to the FY ’25 clinical services budget. Following recent negotiations, the county will pay $472,317 in FY ’26, and PHD’s budget will now receive input from a newly established finance subcommittee under the PHD Board of Health.

As is common throughout the nation, Pennock’s analysis found that the leading causes of death in the northern counties are cancer and heart disease. Citing the Centers for Disease Control and Prevention and the National Center for Health Statistics, he further showed that deaths from infectious diseases have been in steady decline and chronic diseases have been on the rise since the early 1900s across the nation. 

Pennock and Commissioner Ron Korn both pointed to these statistics as potential motivations to shift the district’s focus from reactive to preventative medicine. At the same time, Pennock reported that PHD has seen a decline in vaccination rates, which he attributed to “probably a trust or perception problem,” among other factors.

Though PHD’s clinics exist largely to bridge coverage gaps for low-income patients, the audit revealed that only 9.5% of patients use PHD’s sliding scale when paying medical bills, meaning the vast majority of users have insurance or the means to afford treatment. Pennock argued that, though small, this percentage still ultimately saves taxpayers and area hospitals money in the long run.

“To the extent that a visit in any outpatient clinic prevents a possible urgent care visit, hospitalization or ER visit, there is a savings there that may not be directly seen by the commissioners, but it’s certainly seen in one shape or another by the taxpayers,” said Pennock. “So it’s either going to be federal taxes, state taxes or property taxes.”

Given the relatively low percentage of “indigent” users, the commissioners questioned whether PHD should be “competing with the private sector” by offering the same services as other for-profit organizations. When asked what unique services PHD provides, Board of Health Chair Thomas Fletcher said that he discussed the issue with Heritage Health CEO Mike Baker and his response was, “Nothing. There’s nothing you do that we could not do.”

Despite this, PHD remains a significant provider of women’s health care in the area. Following the passage of Idaho’s near-total abortion ban, the state saw an exodus of OB-GYN physicians and other related providers for fear of legal and criminal ramifications for administering potentially lifesaving treatments. Bonner General Health subsequently shuttered its labor and delivery unit in 2023, directing women to OB-GYNs in Coeur d’Alene; Post Falls; Newport, Wash.; and Libby, Mont. Since then, the number of organizations providing women’s health services has declined.

“There’s a political thing going on here in Idaho with the OB-GYN stuff,” said Korn. “We don’t have any staff — I don’t believe — at Bonner [General Health], because it’s got politicized and weaponized. So is that our issue to deal with? I don’t believe it is. I think it’s the hospital’s issue to deal with.”

Pennock’s audit found that women now account for 70% of PHD’s clinical patients.

“For Panhandle Health — to some extent — that is the niche,” he said. “It’s female patients, women’s health care, gynecology, family planning that is the niche that we’re currently serving, whether we should be or not.”

In response, Korn remarked that PHD’s current services “sound a lot like Planned Parenthood.”

“Correct me if I’m wrong, but I think the federal government defunded Planned Parenthood — if I’m not mistaken — and yet I don’t want to be responsible at a county level to look like we’re funding a Planned Parenthood service,” he continued.

“I don’t disagree and, again, I’m not defending what we’re doing,” said Pennock.

The possibility of hiring a medical doctor for the clinics, which are currently staffed by nurse practitioners, came up briefly, with Korn arguing that rather than dedicating more money to the clinics, PHD should focus on “foundational purposes” such as “the commons, monitoring our air quality, monitoring what’s flying out of our skies, monitoring what’s going into our river.”

The meeting concluded before the end of Pennock’s presentation due to time constraints. BOCC Chair Brian Domke will schedule a follow-up meeting at a yet-to-be-determined date, at which point the commissioners and PHD will discuss plans to apply for funds from the Rural Health Transformation Program. 

Part of the One Big Beautiful Bill Act, the program will funnel $930 million into Idaho over the next five years, which the state will distribute among its counties to increase telehealth and other health care infrastructure in underserved communities.