Future uncertain for Seeley Swan Medical Center with ongoing deficit

The district provides medical and dental services to residents of Seeley Lake and Condon through the Seeley Swan Medical Center.

Its board is weighing several options to keep the center open, like a possible local levy, but concerns continue over whether the money could sustain the health clinic long term. 

"We are hoping and praying that our services now can be maintained, but if they cannot, and they do have to be reduced, any services can be better than no services," Board chair Terryl Bartlett told the Missoulian in an interview Thursday. "I do not want that clinic to close, and we are going to try to do anything we can in our power as a board to assist."

The medical center currently operates four days per week with a nurse practitioner. It also provides primary care, dental services, has an X-ray room and has the tools to treat trauma incidents during emergencies. 

PHC operates the clinic under a long-term contract, but changes to Medicare and Medicaid are making it more difficult to sustain the operation, according to PHC Executive Director Lara Salazar. 

The Trump administration's One Big Beautiful Bill imposed work requirements to Medicaid, among other changes, which could cost billions to nonprofit health centers in the U.S., according to Kaiser Health News.

Those requirements officially hit Montana on July 1, Lee Montana reported, concerning some healthcare groups that the bill could spur the closure of rural health facilities.

Salazar told the hospital district during a public meeting on Wednesday that PHC is cutting costs across its operation in response to the federal changes, and the sparse population of Seeley Lake is not covering the bills of the clinic. 

"We can no longer operate sustaining deficits in this way," Salazar said at the meeting. "We have been really committed to this community and have tried to find other resources to cover that. But again, funding is stagnant. There are cuts."

She said the people PHC serves have an increasing inability to pay, and a system-wide restructuring is underway, impacting other rural clinics in places like Philipsburg. 

PHC asked the clinic to support its operations to address the deficit for fiscal year 2027. PHC did not respond to a request for comment from the Missoulian on Friday. 

The hospital board did not take action at the special meeting, but discussed plans to obtain outside legal counsel and a medical consultant to find a long-term solution to preserve medical services. 

The clinic also needs to come up with a short-term solution to meet the $400,000 deficit for next year, and some ideas include running a levy for voters to consider, as well as selling excess property and lowering its monthly building lease with PHC. 

Other proposals include a mix of financial support while also reducing the clinic's operation to two days per week. 

But members of the board shared concerns over whether the financial support would be able to sustain the operation. Some board members said they have not secured assurance from PHC that the money would sustain existing services. 

"What happens in three years when we are bone dry? What do we do?" board member Bryan Jolly questioned at the meeting. " ... It sounds like we may have a Band-Aid fix, and we need a permanent fix, and I am not sure what that is right now."

PHC's contract with the hospital district expires in 2028, meaning they would not be obligated to continue operating its clinic. The board is looking to get more information on the finances from PHC. 

The clinic has lost services over the last two years. There is no longer a doctor of medicine who works at the clinic, and PHC stopped operating the clinic on Fridays. 

The reductions come as Seeley Lake is dealing with the loss of its largest employer, Pyramid Mountain Lumber, which closed in 2024 and laid off roughly 100 people. 

The loss means there are likely fewer people using the clinic, according to Bartlett, especially those with health insurance. Since the clinic is federally qualified, the medical center offers a sliding pay scale. 

One possible outside funding solution includes the Rural Health Transformation Program, a $50 billion fund set aside to states to shore up rural healthcare infrastructure. 

Montana received $233 million annually for the next five years, according to the Montana Department of Public Health and Human Services, and is currently accepting proposals related to the fund. 

The board is looking into potentially finding a grant writer to secure funds from the program. The hospital district also has the authority to levy property taxes, and currently takes in a small amount from properties in Seeley Lake and Condon.

A proposal from the district calls for a 14.25 mill levy, which would increase annual taxes of a $500,000 home in the district by $57, according to district clerk Andi Bourne. 

A decision on running a levy must be made by the end of July for the proposal to appear on the November ballot. The board will meet next on June 9 to continue the discussion. 

Board member Suzette Baker said the district needs to look at the priorities of the town as it moves forward with a funding plan, including whether to look for other organizations to run the clinic. 

"We are doing everything we can as a board behind the scenes to reach out to as many people as we can, including local representatives," Baker said. "We are doing everything we can to push the narrative that this clinic has to stay open."