*This story has been updated from the original, published in Explore Big Sky on Aug. 9

By Joseph T. O’Connor Explore Big Sky Senior Editor

BIG SKY – At the final public meeting to determine which of two entities would build a critical access hospital in Big Sky, the consultant for Big Sky West Yellowstone Healthcare Direction Committee (BWHDC) advised the group to choose Bozeman Deaconess Health Services.

In a 15-13 vote, the committee voted in favor of the alternative entity, Billings Clinic, a member of the Mayo Clinic Care Network.

Howard Gershon, the private consultant hired by the 29-member BWHDC (one member was absent from the meeting) to investigate the feasibility studies conducted by both BDHS and Billings Clinic, presented a slide show aimed at explaining his decision. Gershon categorized the comparisons and contrasts into categories, and by his standards Bozeman “won,” 5-4.

“The process is good, but details need to be clarified,” Gershon said. “It’ll bring out the best of whatever the end result is, hopefully.”

Both proposals are similar in facility size, staffing and scope. Major differences lie in funding and in the approach to West Yellowstone, a community with six members on the BWHDC, and one that feels it needs expanded healthcare opportunities just as badly as Big Sky, according to Bruce McPherson. Many residents of West have spoken up in previous meetings, expressing their concerns over current treatment in their town.

“There are 10,000 people a day in West during the summer,” said McPherson, a consultant to the West Yellowstone Medical Board, which has been in operation for six years. “We want a good relationship with Bozeman, but they never really focused on us. We have no leverage and Big Sky does.”

In a statement received by EBS Friday, Aug. 9, BDHS explained that it understands West’s residents disagree with the hospital’s plan, but is moving forward with their plan to build a critical access hospital in Big Sky.

“[West Yellowstone does] not support Bozeman Deaconess’ model to continue to partner with the West Yellowstone Community Health Partners (CHP) Clinic to expand primary care coverage and clinic hours in the community…,” the statement said. “… We remain fully committed to working with both communities.”

BDHS plans to foot the initial bill for a critical access hospital in Big Sky while increasing staff in the existing West facility; Billings Clinic is asking for a $5 million investment from the Big Sky community, and plans to accommodate an expanded West health care center.

Mike Scholz, who sits on the committee and is also a member of Big Sky’s Resort Tax Board, said that while the committee hired Gershon to complete the evaluation, the consultant did not necessarily represent BWHDC.

“He had his own rating system,” Scholz said. “I believe the people sitting there [on the committee] had their own systems.”

A silence in Buck’s Montana Room followed committee member Jack Eakman’s announcement that the vote favored Billings.

“I guess it felt close,” said Billings Clinic CEO Dr. Nicholas Wolter. “We both put strong proposals together. If this is where the community wants to go, we would form a 501(c)3 board and get going.”

Bozeman Deaconess CEO Kevin Pitzer agreed that both parties brought their best to the table, and hopes to build a BDHS facility as planned.

“This was a great process,” Pitzer said. “It showed the relative strengths of both proposals. Our aim remains to move forward working with Big Sky and West Yellowstone. The next step is to bid the project and secure bond financing.”

Community members in attendance were unsure of what might happen next.

Hugh Long, who splits his time between Big Sky and New Orleans, has a Ph.D. in corporate economics, and specializes in health care finance. He talked after the meeting with Taylor Middleton, general manager of Big Sky Resort.

“This was an important question to ask,” Middleton said. “We have two incredible medical organizations trying to build a hospital in Big Sky. But I think tonight’s message from the professionals and the committee was ambiguous.”

Long felt the competition was healthy. It shows Big Sky will get the best health care facility it can, he said. “Whatever gets done will not be the same [plan] as was initially in the proposals.”

So who decides which entity will build?

“I do not know,” Long said.

While both BDHS and Billings Clinic feel strongly about the next stage in this tug-of-war over a critical access hospital in Big Sky, somehow, someone must decide who will treat the area.

Once BDHS selects architectural and engineering firms as well as construction managers, according to the release, “BDHS will immediately move to finalize facility design and construction documents and secure required state and local building approvals.”

In a follow-up interview, Jim Duncan, President of the Billings Club Foundation, who was also at the meeting, indicated the conversation isn’t over.

“Throughout this whole process, we said we’d honor what the Healthcare Directions Committee decided,” Duncan said. “We remain very interested in seeing how we can help and want to continue very close relationships with the Big Sky and West communities.”

As he was leaving Buck’s, Wolter said, “I just told Kevin [Pitzer], ‘We have to talk. We can’t build two.’”