Take two of these …

Despite having three candidates, the Board of Carbon County Commissioners (BOCCC) appears to be in a holding pattern in regards to the county health officer following their July 6 meeting. 

For nearly two years, Dr. Wayne Couch has served as the Carbon County Health Officer. In August 2019, Couch was appointed by the BOCCC and was, according to Nurse Manager Amanda Brown, was the only applicant interested in the position. When the contract came up for renewal in June 2020—just two months into the coronavirus pandemic—Brown informed the commissioners, again, Couch was the only one interested in the position.

When it came time to renew Couch’s contract at the June 1, 2021 meeting, however, a number of the commissioners expressed hesitancy as they had received comments and concerns from county residents. Chief among those concerns was Couch was no longer a local physician, having left Rawlins in 2016. Insisting the process be as transparent as possible—and despite testimony from Nurse Jacquelin Wells in regards to verbal abuse aimed towards Carbon County Public Health and Couch during the pandemic—the BOCCC opted to attempt to reach out to other physicians.

Dr. Duane Abels, who is currently employed by Memorial Hospital of Carbon County (MHCC), and Dr. Susanne Levene provided applications along with Couch. Brown, who was in attendance on July 6, provided her recommendation to the commissioners, asking they remain with Couch as the county health officer.

“I have not had the pleasure of working or meeting with Dr. Levene so I can’t comment on any of that but I do believe Dr. Abels would be an excellent county health officer if there were different circumstances,” said Brown. “We have an excellent relationship with him, we’ve worked very well with him during the pandemic and before and I feel like he played an essential role in our response to the pandemic.”

Brown added while she could see the benefit in having a local physician as the county health officer, Couch had served as the health officer for approximately 18 months and had experience with the staff at Carbon County Public Health.

“He understands how we operate, he has gone through all of our training, he has signed all of our guidelines and orders and he has the relationship with the other county health officers around the state (and) with the state health officer,” Brown said. “I think a lot of these are important and it helps us operate at our best. Since COVID hit, I do feel like he stepped up and he did everything that we needed him to do. He worked really well with our team, he didn’t come in and just run the show where (in) some other counties that is what happened.”

She went on to inform the commissioner of the logistics involved with changing county health officers. According to Brown, Couch’s physician’s license is tied to nearly everything Carbon County Public Health does. This included billing platforms and applications for Medicare and Medicaid.

“Another thing to consider; I do think there’s a benefit of having an outside doctor serving in this role for our community. I think it gives us a larger field of vision, we’re able to see the health of Carbon County in a larger way and having somebody that’s not directly tied to one medical sector or one facility within our county, I think, is beneficial,” said Brown. “There’s no conflict of interest and you get that broader look to our county.”

Brown went on to state that before Wyoming experienced its first COVID-positive case, Couch had been treating COVID patients in Colorado and was able to bring that experience to Carbon County Public Health and Wyoming.

Commissioner Sue Jones told her fellow commissioners they need to think critically and honestly about their reaction to the position of county health officer, citing the reactions of other county commissioners in the state. In November 2020, Dr. Ed Zimmerman was removed as the Washakie County Health Officer and, in January 2021, the Weston County Commissioners removed Dr. Mike Jording as their health officer.

“Some county commissioners reacted in anger and fired them all immediately, which, how much good does that do them because you’re firing a guy that isn’t your guy, ultimately, anyway. We were smart enough, as a group, to understand how the system worked,” said Jones. “Whether he lived here or not is totally irrelevant. It is about the job and so I would hesitate to just react because we’ve taken a lot of flack from the public about having Dr. Couch ‘who’s not from here’ which I don’t think anybody else would have reacted any differently.”

While Jones voiced her opposition to “switching horses midstream”, other commissioners did not appear to share the same opinion.

“Of all the things that I’ve been involved with as a commissioner and as an elected official and my service here, this has been the thing that I’ve received the most comments about,” said Commissioner Byron Barkhurst. “I appreciate Dr. Couch and the work that he’s done but I cannot, for some reason, get my head around the way that the mask thing was handled.”

During the November 17, 2020 meeting of the BOCCC, Couch announced a county-wide mask mandate. While there had been expectations of a statewide mandate being issued, the county-wide mandate came as a shock to many and was coordinated with several other county health officers. Couch told the commissioners that while he understood the concern people had about their civil liberties, the county needed all the dents it could get in flattening the curve.

“I think if we really dig deep into it, it is more about the freedoms and the liberties and those rights that were taken into consideration and were questioned at that time,” Barkhurst said.

Commissioner John Espy said the question he had been asked the most during the 2020 election cycle was why the BOCCC was sending Carbon County money down to Colorado.

“Dr. Abels has done a lot for this community. He has saved a lot of people’s lives in that emergency room and he’s been here in some of our darkest hours in that hospital and he didn’t bail on his community,” said Espy.

Commissioner Travis Moore, meanwhile, said he was torn between Dr. Couch and Dr. Abels.

By a show of hands the commissioners overwhelmingly supported a contract with Abels.

Jones was the lone supporter of Couch.

As discussion followed, questions were raised as to Abels’ liability insurance which would be required to serve as Carbon County Public Health. While Couch had his own liability insurance, Abels’ came from MHCC. The most concerning question appeared to be if MHCC’s liability insurance for Abels’ would or could cover him as the county health officer.

By the time the meeting adjourned, however, no answer was provided. At this time, Couch still serves as county health officer though his contract officially expired on July 1.

The next meeting of the Board of Carbon County Commissioners will be at 9 a.m. on July 19 at the Carbon County Courthouse in Rawlins.