On a recent Friday morning, two high school students were working in tandem in Gillette College’s diesel technology workshop. They’re the youngest students in the program and often work together.
They’re not out of place, though; they’re exactly where they’re supposed to be.
One of the pair, Jacob Randall, an 18-year-old student at both Westwood High School and Gillette College, will celebrate two graduations in the coming weeks. He’s not the first student in the Campbell County School District to earn an associate degree from Gillette College at the same time as his high school diploma, nor is he the only one this year.
But he’s the first Westwood student to do it.
Westwood High School is an alternative high school, which can mean different things for people depending on their perspectives. It gives some a second chance to get a high school diploma. For students like Randall, it’s an opportunity to take advantage of the options presented by the school district that implicitly understands there isn’t just one way to do high school.
Randall was a student at Campbell County High School for much of his high school career, but it wasn’t an easy and comfortable fit..
“I had no interest in going to school,” Randall admitted. “I was ready to just be done with it, get on with life, figure something out.”
Randall said he’s a hands-on learner. At CCHS, he enjoyed things like construction, woodworking, welding, small engines, but there are lots of other requirements that a traditional high school can place on students that don’t allow for a complete immersion in the content areas in which he was most interested.
Two things helped Randall stay invested in his education when he might have otherwise given up: Westwood High School and the dual-enrollment program with Gillette College.
Westwood’s alternative format allowed for him to focus on just the core classes needed to graduate high school with a great deal of flexibility to allow him to continue with his Gillette College classes in diesel technology.
His mother, Roxanne, called the combination a blessing.
“For Jacob specifically, he was bored at school,” she said. “He just hated it. He didn’t want to keep doing it. He wanted to get on with life, so this was like a perfect fit for him.”
There’s no point in pondering the what-ifs in life, but Randall was self-aware enough to know his could look a lot differently were it not for Westwood and Gillette College.
“If it wasn’t for the dual-enrollment, I wouldn’t have gone to college,” Randall said. “But since I was able to do college and high school at the same time, it kind of helped me.
“Now I’m getting my degree at the same time that I would have graduated high school. So really, the time difference was nothing, but I’m getting two separate things at the same time.”
The diesel technology program is a practical educational experience that feels more purposeful to Randall.
“I think it’s a fantastic program,” he said. “They teach very well. There’s a lot of hands-on. That’s how most of the people who go into the trades, they learn well with their hands. And most of the stuff they do is hands-on, which is fantastic.
“If we’re learning about the engine, they have an engine there for us to work with. Or the computers or whatever, they have something for us to put our hands on, touch, learn about and look at all angles. That’s very helpful.”
It’s a different experience from a typical high school class, he said. It also more focused.
“When I go to the diesel classes, I’m not learning about 10 different things,” Randall said. “It’s more direct, like, ‘This is what we’re learning in the class. And this is how we do it.’ Whereas at high school, in your English class, you learn so many different things but you hardly touch any of them.”
Randall is a quiet young man and seemingly ill at ease with any attention being given to his accomplishments. It’s just not his style. If he’s excited about the two graduation ceremonies, one would never know it from his outward appearance.
“I guess I’m just ready to be done with it,” he said. “It doesn’t really excite me that much to walk across a stage or whatever. I’m ready to be done with the program and keep moving forward.”
That response doesn’t surprise his mother.
“Jacob, in particular, has always been an impatient child,” Roxanne said. “He’s always been like, ‘I want to get up and get going.’ So that has been his nature.”
But she and many others who’ve helped out along the way are incredibly proud that in a relatively short time, Randall has progressed from contemplating dropping out of high school to not only earning his diploma, but an associate college degree at the same time.
Brent Heusinkveld, the longtime diesel technology instructor at Gillette College, said it takes “real commitment on those kids’ parts to take that on.”
“Not every high school student has that level of maturity,” Heuskinveld said. But Randall had it in spades.
Jeff Wasserburger, a state senator and executive director of the Board of Cooperative Higher Education Services, was instrumental in helping Randall and other high school students enrolled in college classes.
The dual enrollment program began in 1993 when BOCHES was established in Gillette. BOCHES allows high school students to get their college credits paid for by scholarships, saving them money.
“He’s been a wonderful student,” Wasserburger said. “Never at any time did he struggle. He’s our first kid ever from Westwood (to achieve dual graduations). … It’s amazing to me.”
It isn’t just a personal accomplishment, Wasserburger said. Randall is an example for his Westwood classmates of what’s possible.
“He’s changed the debate, changed the discussion, at Westwood from, ‘I’m going to get a high school diploma’ to, ‘I’m going to get a college degree,’” he said.
The Randalls couldn’t speak highly enough of Wasserburger for all of his help.
“He’s like a huge advocate for it,” Roxanne said. “He’s just willing to give everyone a chance, and he’s been wonderful.”
They were introduced to Wasserburger by Kristin Young, the college’s GEAR UP site coordinator.
Gaining Early Awareness and Readiness for Undergraduate Programs is a statewide U.S. Department of Education-funded grant initiative that helps seventh through 12th graders get ready to transition to post-secondary life. Randall became involved with the program when he was in seventh grade, and said that Young was one of the most helpful people throughout his education.
“His accomplishment is really special because he was able to use the resources available to him to get a maximum benefit,” Young said.
“He’s a great example for other students and shows them that it’s possible,” she said. “You don’t have to end your high school career and not know what’s next.”
There are a lot of other students for him to inspire, Young said. This year, GEAR UP students have accounted for 389 college credit hours, which is worth about $55,400 in tuition. They had 31 students in the fall and 43 in the spring taking classes at Gillette College.
Westwood itself was a key to Randall’s success, Roxanne said.
“Westwood was really helpful,” she said. “They’re super willing to work with you. It wasn’t quite as easy (at CCHS), but at Westwood, their focus is to get you graduated.”
The school was willing to accommodate the specifics of his unique situation.
“His high school and college classes overlapped by a half hour,” Roxanne said. “They were like, ‘That’s fine. You leave your class early. You’re responsible for it, but you’re fine to leave.’”
A key to that mindset was Westwood’s principal, Kelly Morehead.
“We spoke to her directly, but they only take a certain number of students,” Roxanne said. “It’s not open for everyone. You have to apply and go in and tell them why you want to go there.”
“Jacob was a great student,” Morehead said. “Probably what kept him going through high school was that college degree and getting out there and doing what he wants to do in life.”
At Westwood, students primarily just need something a little more catered to their needs, Morehead said.
“For Jacob, it was that he wanted to get that college degree and move on, but he needed two core classes,” she said. “We have to look to see if we can build a schedule around the college schedule to keep him on track for graduation.”
Morehead said there were 20 students taking dual-enrollment classes in the fall, and 15 in the spring. That’s the most taking duel-enrollment classes at Westwood in a school year.
Wasserburger that was the dream for Westwood when it was built behind Gillette College’s Technical Education Center, so that students would be encouraged to take college classes. It’s a strategy that’s clearly paying off.
As talks of a potential affiliation become more tangible, the goals and expectations of a deal between Campbell County Health and UCHealth are taking form.
After a special meeting and executive session this week, the CCH board of trustees directed administrators to negotiate a letter of intent with UCHealth, a Colorado-based health care system, to craft a potential agreement that could provide management and IT services for CCH.
The hospital board asked administrators and its legal council to have the letter of intent prepared by its next regular board meeting, which is May 27.
Leading up to that meeting, CCH will host a series of listening sessions to gather feedback from employees and also host an in-person community town hall sometime in May.
If an affiliation agreement is to be reached, questions remain over what impact it could have on CCH and its community of patients.
Compared to CCH, UCHealth is a giant in the health care industry. The Colorado-based nonprofit system has 25,000 employees and 12 acute-care hospitals staffed with hundreds of physicians.
Its reach extends into Wyoming and Nebraska.
UCHealth has standing affiliations with two other Wyoming hospitals in Cheyenne and Laramie. Its deal with Ivinson Memorial Hospital dates to 2013 and it has been in partnership with Cheyenne Regional Medical Center since 2018.
There have been several potential partners vetted throughout the years that CCH has explored affiliations with, said CCH CEO Colleen Heeter.
The difference now is that UCHealth can offer benefits at a larger scale, such as cost savings and more medical resources, while ensuring CCH remains independent in Campbell County.
“CCH has been exploring how to elevate the care that we provide our patients and the community while maintaining our independence and autonomy,” said Adrian Gerrits, chairman of the hospital board of trustees, in a press release.
“We believe exploring a relationship with UCHealth, who would potentially be an excellent partner, because they have a similar mission and values to help achieve these goals. We look forward to input from stakeholders. Our goal is to provide the highest quality care to the patient closest to home. ”
What CCH could get?
Economy of scale has been a recurring phrase in the brief public discussions between the hospital board and administration about possible affiliations. With scale comes greater purchasing power, which local officials expect would lead to lower expenses for CCH, ultimately padding its bottom line.
“Of course, we’re a small entity, but with their help we can save money in the community, save money in our bottom line for supplies, implants, just overall capital,” Heeter said.
Another key factor for CCH would be the integration of EPIC, an electronic health records system that would be a major improvement over the organization’s current software.
Implementing EPIC could create a more efficient and effective process for physicians and patients through less frustrating record keeping and improved patient portals.
Heeter said that incorporating the new health records system could improve the organization’s billing, which has been a point of frustration for patients, administration and physicians.
There also is hope that an affiliation would help CCH attract and retain doctors.
While an affiliation will not solve the struggles a rural health care system has with recruiting and retaining physicians, Gerrits said he believes it will help.
“I think physicians have trepidation about coming to a rural community and practicing rural medicine because the support systems around them aren’t necessarily there,” he said.
Some of the service lines most important to the community are not profitable for CCH. Gerrits named behavioral health, dialysis and cancer care services as areas that are valuable to the community and could benefit from greater purchasing power.
He emphasized that there is no interest in getting rid of those services locally. But to keep them in the community long-term, CCH has to explore ways to make them more financially viable.
“What do we look like in the future as our community, we lose more mill levy and our community, if it starts shrinking? We’ll have to take a hard look at those things,” Gerrits said. “And it won’t be a UCHealth thing, (it will be) just because our bottom line can’t support it. That is the reason we’re trying to cut costs in other ways.”
What’s in it for UCHealth?
Largely, the question of what’s the benefit of an affiliation for UCHealth remains unclear.
“I think that’s a good question,” said trustee Dr. Sara Hartsaw about what UCHealth would gain from the partnership. “Right now, I’m not sure.”
Speaking for herself as a physician and local resident, as opposed to a hospital trustee, Hartsaw said she agrees with exploring the opportunity but still has questions about how it will affect the organization and community.
“How can we make this better? Is this the best way to make things better? What are we missing in this?” she said. “I think those are some of the areas of concern that I have.”
An affiliation between the agencies would expand UCHealth’s reach in the region while also expanding a potential referral network to Campbell County. While CCH doctors would not be required to send referrals to UCHealth, they very well could recommend patients seeking services not offered in Gillette to other affiliated hospitals in Colorado.
“They’re trying to build relationships with smaller communities so they’re the first choice,” Heeter said. “They want to earn our business when we have something that’s outside our scope of care.”
UCHealth Vice President of Operations Grace Taylor, who attended this week’s special meeting remotely, said her organization can’t solve all of CCH’s problems. However, she expressed optimism that there are areas where an affiliation between the two could benefit CCH.
“We want to support this organization if we can,” Taylor said. “We share your anxiety and your trepidation a little bit as well. With all new relationships, I think things take time to grow and we have to build trust, and that’s the big message that I wanted to share with you tonight. We do thank you for the potential here.”
Hartsaw said that having nearby health care systems in Cheyenne and Laramie that have affiliated with UCHealth gives CCH the chance to connect with those employees and physicians who have already gone through the process.
“I think it’s a good first step,” she said. “I don’t know whether anything in the end will happen, but I think we’ve got to start talking to another organization to consolidate some of our needs.”
Making an impact
Like many things, interest in and the details of an affiliation may come down to money.
Hard economic times have fallen on rural hospitals in recent years. Throughout the country, 101 rural hospitals closed between January 2013 and February 2020, according to a report by the federal Government Accountability Office.
The COVID-19 pandemic has exacerbated the issue.
Even after the pandemic, a study commissioned by the American Hospital Association found that rural hospitals could be hit especially hard during the recovery year while effects from COVID-19 linger.
Its model anticipates, in an optimistic scenario, that slight improvements could happen early before later plateauing below pre-pandemic levels. The more pessimistic projection, described as “very bleak,” could see no improvement for rural hospitals throughout 2021.
Furthermore, “at least four dozen” hospitals entered bankruptcy or closed in 2020, the American Hospital Association reported, crediting Bloomberg data.
Without one-time pickups that came as a result of pandemic relief this past year, CCH expects it would have ended fiscal year 2021 at a $3.5 million loss, CCH Chief Financial Officer Mary Lou Tate said at this year’s board retreat.
“This is the fifth year Campbell County Health lost money, and if we didn’t have one-time pickups this year we would have lost almost $4 million. That’s after the tax impact,” Tate said at the retreat.
Projecting ahead to the next fiscal year, Tate said she expects a $5 million loss.
The organization received about $8.5 million in one-time pickups from CARES Act money and insurance and litigation settlements that helped keep the organization on solid financial footing this year.
CCH levies 3 mills of property tax annually. With Campbell County’s assessed valuation decreasing lately, the amount of money it receives has decreased as well. In its current fiscal year’s budget, CCH anticipated receiving $10.8 million in local tax revenue.
Tate said the tax mill CCH receives is about 6% of its total revenue for fiscal year 2021.
While the board of trustees has the ability to assess more than 3 mills, Gerrits said that is not being considered. But the reduction in tax revenue is one of several factors leading the organization to seek cost-saving measures.
“There’s not going to be any entertainment of tax dollars leaving Campbell County to go to UCHealth,” Gerrits said.
“The agreement that we would be comfortable with would be, it’s a very loose relationship that we want to develop with them. The intent is not to have someone manage the hospital for a fee … our goal is an affiliation.”
The Campbell County Commission would ultimately have to approve any contract agreed upon between CCH and UCHealth.
“We’ve known for quite sometime, we see the newspapers, we see rural hospitals struggling,” Heeter said. “So developing a relationship with somebody who’s got a strong bond rating, who’s got a lot of cash, who’s got a lot of knowledge and a huge workforce will help us for the next 10 to 20 years.
“We want to be here in northeast Wyoming for a long time. So, affiliating, we believe, is a non-threatening answer for us.”
For the second straight year, Gillette Reproductive Health will not receive money from the county’s Optional 1% Sales Tax revenue.
The organization had applied for $25,000 to pay for preventative wellness exams for uninsured or underinsured women in Campbell County. During the Campbell County Commission’s budget discussions this week, the board decided not to fund the agency in fiscal year 2021-2022.
Last year, the commissioners also decided to cut Gillette Reproductive Health’s county funding to zero based on a claim that the organization was doing abortion referrals.
Commissioners Del Shelstad and Colleen Faber were the most outspoken and based their decision on their anti-abortion stance. They were concerned that Gillette Reproductive Health did abortion referrals and gave birth control pills to minors without parental consent.
Gillette Reproductive Health repeatedly denied the claims.
This year, the commission spent just a few minutes talking about the organization before again deciding to deny its funding request.
“It’s a little bit disheartening when you’re the only nonprofit in town that’s picked on for no reason,” said Gillette Reproductive Health Director Julie Price Carroll.
Technically, the decision will not be final until the commissioners officially approve the county budget in June.
Commissioner D.G. Reardon supported Gillette Reproductive Health last year and said he remains “disappointed that most of the board didn’t want to talk about it. I wanted to discuss it in more depth.”
“I didn’t see any reason to hash out the same thing we did last year,” said Commissioner Rusty Bell, who along with Reardon was one of two commissioners last year who supported the agency.
Last year, Reardon started a fundraiser to raise private dollars to help make up for the lost county funding. He said he will likely do the same thing again this year.
For each of the seven years leading up to 2020, the organization had received $25,000 from the county for the sole purpose of providing wellness exams.
Price Carroll said the money helped lower the costs women have to pay to get a wellness exam. With the county funding, the exam costs $25. Without it, the exams range from $145 to $250.
In 2019, then-President Donald Trump changed the rules for the federal Title X family planning program to forbid any provider that received funding through the program to provide abortions or do abortion referrals. Gillette Reproductive Health is one of those providers.
In 2020, Price Carroll repeatedly said that as an organization that receives federal funding from the Title X Family Planning Program, Gillette Reproductive Health was prohibited from referring patients for abortion care.
Shelstad said the Biden administration changed the rule, which opens the door “so (Gillette Reproductive Health) can do abortion referrals.”
“I don’t want to automatically assume that they’re going to do that,” Shelstad said. “But they don’t have that argument this year.”
Price Carroll said that as far as she knows, the rule has not been changed.
Gillette Reproductive Health raised $23,696.94 in private money in 2020, and all of it went toward wellness exams. Thirteen women who were helped by the donations were referred to have a loop electrosurgical excision procedure after they were found to have abnormal or precancerous cells, Price Carroll said.
During the pandemic, the clinic never closed its doors and stayed busy throughout the year. It picked up STD appointments that Campbell County Public Health stopped doing because it was dealing with COVID-19, and “we also were able to help two other OB/GYN clinics that shut down,” Price Carroll said.
She said it feels like Gillette Reproductive Health is being singled out by the commissioners.
“If they were to tell every single nonprofit to go ahead and pull that (private funding) from all the community members, that’d be one thing. If they said, we’re going to cut you all by 10%, I would understand that too,” she said. “But to take one nonprofit that’s really vital to the health of your community and say we’re not going to fund you based on things that are misnomers, is not fair.”