PHD prepares to submit budget proposal, institute clinic changes

By Soncirey Mitchell
Reader Staff

In preparation for their upcoming Fiscal Year 2027 budget proposal, representatives of Panhandle Health District met May 5 with the Bonner County Board of Commissioners to discuss anticipated expenses and changes to area clinics. Due to previous negotiations with the BOCC, Bonner County reduced its funding contributions by $41,481 in FY ’25 and has indicated it will request further reductions if certain clinical and policy changes aren’t met.

The five northern counties — Benewah, Bonner, Boundary, Kootenai and Shoshone — fund and benefit from the health district, which, among other functions, hosts clinics five days a week at its headquarters in Hayden, once a week in Sandpoint, and once a week divided between Kellogg and St. Maries. 

During recent negotiations, the BOCC argued that Bonner County does not receive enough clinic days, given the $472,317 it paid into the district in FY ’26.

PHD anticipates total expenditures for FY ’27 to be $12.299 million, funded through taxes, medical bills and public health application fees.

“Taking a 10-year look back, there have been a couple of years where we have asked for additional funds, but if you look overall, we’re asking for less than we were asking for 10 years ago,” said PHD Director Erik Ketner at the May 5 meeting.

Going forward, the district must also contend with reduced funding from state and federal health and welfare sources following budget cuts from The One Big Beautiful Bill Act.

“Costs go up, but the amount of funding that we see in grants and subgrants reduces,” said Ketner. “So, we’re trying to make more with less.”

Large anticipated expenses include a 2% cost-of-living adjustment for employees, salaries for new hires — including a social worker, two medical assistants, a nurse practitioner and a public information officer — and repairs to the Hayden office’s 20-year-old roof. 

PHD is still negotiating with distributors, applying for bids and altering fees — beginning with septic system applications — in an attempt to move toward “more budget neutrality.”

“They obviously make money in the private sector,” said PHD Medical Director Gregory Pennock. “I don’t know why we can’t do it in public health. So, you should hold me responsible. You should hold these guys responsible for this budget. If I come back next year and we haven’t made good progress in this regard, then you should get rid of me.”

Following Pennock’s comprehensive audit of PHD’s clinical services, the Board of Health has proposed policy and practice changes intended to “solve the chronic disease epidemic” by incorporating naturopathic medicine while preserving “data-driven scientific medical approaches that you might see with more traditional allopathic medicine.”

“We’re trying to solve access to care and physician shortages, gaps in health care services, and an image problem with the health district, maybe a marketing problem, where we need to get the word out of what services we actually provide to the counties and to the people,” said Pennock.

Commissioner Ron Korn — a frequent PHD meeting attendee — argued that, in addition to these changes, the district must develop protocols to ensure informed consent for all patients, going beyond the information PHD provides from the Centers for Disease Control and Prevention.

“I’m drawing a hard line here, guys, that I want to see informed consent if you want me to pass off on any budget,” said Korn, citing vaccine ingredients, side effects and clinical trial lengths as crucial information for the clinics’ patients.

Pennock agreed on the importance of informed consent, and said that, in addition to information from the CDC, PHD would like to develop a “generalized consent packet” with relevant background information chosen by the board.

“I want to make a very important point — and my staff always gets on me when we have these discussions with commissioners and so forth and they’re absolutely correct — we are practicing informed consent in our clinics right now — we are,” added Pennock. “So, the nurse practitioners that are seeing patients are describing potential risks, benefits and alternatives. What we don’t have is a formalized process to do that.”

Commissioners from all five northern counties will meet with PHD at a to-be-determined date to formalize the FY ’27 budget. Regular PHD meetings are every second Thursday of the month, beginning at 1 p.m. Watch online on Panhandle Health District’s YouTube page.