Tuesday, May 3, is Election Day for special districts of all types, but in Delta County only the hospital has more candidates than seats to be filled on its board of directors. Elections for the North Fork Pool, Park and Recreation District, the county's five fire districts and its two mosquito control districts have been cancelled. Board vacancies were declared filled when the number of vacant seats equaled the number of candidates. In some cases, appointments will be necessary to fill vacancies.

For the hospital board election, all active voters in Delta County will receive ballots. There are two open seats and three candidates -- Jean Ceriani, David Lane and Curtis McCrackin.

Ballots will be mailed the week of April 11. They must be returned by 7 p.m. Tuesday, May 3, either by mail or in person at the county courthouse or the North Fork Annex in Hotchkiss.

The five-member hospital board is currently comprised of David Lane, board chairman; Bill Hellman, John Breit-

nauer, Jim Briscoe and Jeffrey Berkosky. Dr. Berkosky recently resigned from the board, citing a conflict of interest since his practice, Internal Medicine Associates, is operated by the hospital. John Breitnauer is term limited and will not be seeking re-election.

So while there are actually three vacancies on the board, Dr. Berkosky's seat will be filled by appointment. Electors will select the other two board members. There are no representative districts; board members serve at large.

David Lane previously served two terms on the hospital board. Hospital bylaws require that term-limited board members sit out for two years before again seeking election to the board. Lane allowed that time to pass, and in 2012 was again seated on the board.

As he completes his four-year term, he says his financial background, his previous experience and his desire to continue doing the right thing for the hospital make him a qualified candidate for the board.

Lane is a certified public acountant but has been interested in medicine since he served in the military medical corps 44 years ago. "The medical field is an interest of mine, and one I don't get to otherwise pursue as an accountant."

Of primary importance is ensuring the hospital grows along with the community. That may mean expansion of the facility itself, as well as adding services and physicians. "As the population ages, we have to change our thought process," he said. "We need to look at the needs of the community and try to address those needs, much as we did with the addition of an oncologist several years ago.

"Additionally," he said, "the Affordable Care Act has placed many demands on the medical profession, including billing procedures, health wellness incentives, medical records recording procedures, and the list goes on."

Curtis McCrackin has owned and operated small businesses for over 25 years, and has helped his wife with her small surgery practice for nearly 20 years. That experience, plus attendance at hospital board meetings for two-plus years, has provided him with a working knowledge of the business of medicine.

When asked about the biggest challenge facing rural hospitals, he responded:

"Without a doubt the biggest challenge facing any hospital is that Medicare in 2018 will change the payment method for physicians and hospitals. We will move from a (FFS) fee for service model to a (VBS) value-based system. This is part of the Affordable Care Act and is designed to capture billions of dollars in savings from health care.

"One should ask themselves where will the money come from? Hospitals and physicians will be forced to provide care based on Medicare's desire to pay for care. As always, the private payers will follow Medicare's lead to cut their costs to provide care. This could have a significant impact on the hospital's bottom line.

"I think DCMH is going to need to focus on its own business model. What services can we provide to the community? What options are available in working inside the new payment model? What should we not be doing? The next few years will be difficult for anyone who provides care in medicine."

Jean Ceriani has been involved in the delivery of health care for more than 35 years.

She explains, "My entry into medicine was in 1977, when I attended the LPN program at the Delta-Montrose Vocational College, with my first nursing job at the 'new' DCMH (now the oncology and classroom center). This gave me a way to work, continue my education and be a single mother. After leaving Delta County, I worked in hospitals, clinics, operating rooms and finally in 1990 graduated from the University of Utah`s physician assistant program.

She and her husband, a retired orthopedic surgeon, decided to work with the underserved population in Gallup, N.M. After nine years, they happily returned to Delta County and

Ceriani went to work part-time for the North Fork Clinic.

"My experience in all phases of health care management, both in hospitals, and in outpatient management environments, has prepared me to be an active and enthusiastic participant on the board of directors of DCMH," she explained.

"Our current hospital board and hospital management team has done an excellent job of preparing the hospital for continued growth in a rapidly changing healthcare environment. We can no longer count on the in-patient side of hospital care to remain profitable enough to keep our hospital healthy. We must now look to outpatient care, preventative care, and other rural hospital alliances for support in our delivery system. We must look at ways of recruiting and retaining new healthcare providers, when we know that the shortage of primary care providers will only get worse as time goes on. We must find a way to care for all the residents of Delta County and remain a viable healthcare system.

"It is imperative that DCMH remain the central hub of healthcare in Delta County. It is my intent, as a board member to assist in that vision in any way I can."


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