Proudly Serving

Proudly Serving
Providing veterans in our community the care they need

By: Jeannie Harkness, Clinic Manager
Boundary Community Clinic

Boundary County has a community that sets the example when it comes to service and honor. With more than 1,500 veterans located in Boundary County, we are fortunate to have retired, reserve, and active duty service men and women living here. As a rural community, it has been frustrating for many veterans to find local healthcare services as part of their VA benefits. Stories abound of veterans driving round trip to the VA Center in Spokane for a ten minute appointment.

Luckily, the Veterans Administration (VA) has been striving to change the situation and make healthcare more accessible for those that have served our country and live in our community. In August 2019, VA awarded TriWest Healthcare Alliance a contract to administer the new Community Care Network (CCN) in Region 4 which includes Idaho. TriWest is responsible for building and maintaining a network of community health care providers, paying claims, and providing customer service under the CCN contract.

Boundary Community Hospital (BCH) has always been committed to caring for the Veterans in our community. In order to facilitate care for these patients, BCH has instituted several processes to expedite services, improve communication, and provide the necessary information so that services can be billed appropriately and accurately.

As the primary local health resource, BCH strives to add service-lines if a need is recognized and works with local healthcare providers to streamline processes to make it easier for veterans and their families to access the care they need.

As the Clinic Manager, I’m thankful Boundary Community Clinics, a division of BCH, has been added as a new Urgent Care site for veterans within the last year. We are currently the only VA Authorized Urgent Care facility in Boundary County. The clinic is always accepting new patients and their families with VA Insurance Plans such as Veteran Patient-Centered Care Clinic (VAPCCC), Tri-West Healthcare Alliance, and Tri-Care insurances. Additionally, the clinic is in the process of potentially expanding services to include Annual Disability Exams to better serve those veterans with disabilities in our county.

Due to the constant program changes that veterans and healthcare organizations faced, local veterans have struggled to access outpatient services available in Bonners Ferry such as lab tests and x-rays. When the 2019 Mission Act replaced the VA Choice Program, specific processes were put in place for veterans to receive care from local providers. It also gave healthcare organizations the understanding of what needs to be completed in order to care for a veteran at their facility. One component that has not changed is that all veterans require authorization for services prior to being seen in an outpatient setting, unless it is an emergency room visit.

As a hospital and primary care clinic trying to serve the veterans of our community, we can direct veterans through the process to ensure authorization has been obtained for services needed, creating a smooth transition from one area to another. We coordinate with the VA to ensure that billing is handled properly so that our veterans are cared for appropriately. We are honored to have veterans in our community, and to be able to provide veterans with the care they need.

This Veteran’s Day, and every day, we are proud to serve those who have served our country.

Early Detection

Early Detection – Tests That Can Save Your Life

By: Susan Layeux, MD
Boundary Community Clinic Medical Director
March 2020 Bonners Ferry Living Local

Screening for the most common cancers is highly recommended by organizations like the American Cancer Society (ACS), the American Academy of Family Physicians (AAFP) and the U.S. Preventive Services Task Force (USPSTF).  As primary care providers, it is our goal to detect treatable cancers early, to decrease the burden of disease and death.

Many people decline screening tests because they do not have symptoms.  But the reality is, most cancers do NOT have symptoms in their early stages, when they are the most curable.

The four most common cancers are: Prostate (in men), Breast (in women), Lung, and Colorectal cancer.

Lung cancer accounts for more cancer deaths than colorectal, breast and prostate cancer combined.

Some current screening recommendations:

  • LUNG cancer screening is recommended for any person age 55-80 who has smoked the equivalent of 1 pack per day of cigarettes for 30 or more years, and is either still smoking or quit less than 15 years ago. That is done with a limited (lower radiation dose) CT scan of the lungs.
  • COLORECTAL cancer screening is recommended for all adults aged 50-75. The three most common ways to screen: 1) Colonoscopy every 10 years; 2) a stool test for blood and DNA shed from cancerous/precancerous cells (current one on market is Cologuard) every 3 years; 3) or a stool test for blood, every year. Colonoscopy is still considered the “gold standard”, and people must understand that if they have a positive screen in one of the stool tests, a diagnostic Colonoscopy will then be recommended.
  • BREAST cancer screening is recommended for all women from ages 50-75 using a 3-D Mammogram. The various societies have disagreement with how often to screen between the ages of 40-50, and the interval of screening (every 1 or 2 years). Much depends on family history.
  • PROSTATE cancer screening recommendations have changed. The only current available test is a blood test called PSA (prostate specific antigen), used to test men from ages 55-69. However, it is an inadequate screen because a high PSA is not only seen with cancer. It can be high because of an enlarged prostate or a prostate infection. Screening is individualized based on your history.

The details about benefits and risks of each type of screen can be found on the USPSTF website  They give the recommendations for the average person as well as every exception.  Our goal at the Boundary Community Clinics is to keep current with the guidelines and present each patient with the best recommended screening based on their personal and family history, and to answer questions about risks. The good news is, Medicare and most commercial insurances cover screening costs at 80-100%.

Early cancer detection saves lives. Please do not wait until you have symptoms to be screened. Talk to your Primary Care Provider about what screens are right for you.

Prescription for Wellness: First Aid on the Trail

First Aid on the Trail

By: Dr. Susan Layeux, Boundary Community Clinics

In Boundary County, we head out to forest and river trails to hike, pick berries, find mushrooms, track animals, hunt, ride mountain bikes, snowmobile and ride ATVs. Most excursions will never end in someone needing First Aid. However, as the mother of three Eagle Scouts, I would have to agree with the Boy Scout motto: “Be Prepared”. That is the first key to Trail Safety and First Aid. We need to be aware of our surroundings and the obstacles or animals we may encounter that could result in injury. So I will share some key ways to be prepared.

Carry water. Avoid dehydration by bringing along enough water for the time you plan to spend outside. The higher the temperature, the higher you go in altitude and the more physical you are, the more water you need (even in the winter). The base should be 8 ounces per hour. If you stay hydrated you are less likely to experience Fainting, Heat Stroke and mental dullness that can lead to other injuries. Water can also be used to wash wounds and to cook. Sometimes a simple water bottle per person is enough, but the Camelback backpacks are great if you will be out for hours.

Pack a basic First Aid kit. This could include antiseptic wipes or alcohol pads (or water), antibiotic ointment, assorted bandages, small tweezers for slivers (or ticks), gauze pads of various sizes, tape (even duct tape), elastic bandage (Ace wrap or Coban wrap that sticks to itself), moleskin or gel pads for blisters, burn cream packets, scissors, safety pins, hand sanitizer, triangular bandage or bandana (makeshift sling). You could even consider disposable non-latex gloves and a CPR breathing barrier if you will be far from help and in a large group. A few baby Aspirin and some Acetaminophen or Ibuprofen can be handy. And many kits come with a small first-aid booklet or guide to how to handle various injuries.

On insects. Prevent tick and mosquito bites with proper clothing and your favorite insect repellent. Check for ticks at the end of each day, and remove by grasping the head (if possible) with tweezers and pulling steadily and firmly. Prepare for hornet or bee stings. If allergic, be sure to bring your Epi-Pen. Even if not, bring a few Benadryl 25 mg (diphenhydramine) and take one immediately if there is significant trouble with swelling or breathing. This can also be used if you develop a rash from exposure to poison ivy or other noxious weeds.

Prepare for the weather. Apply sunscreen every 1-2 hours to exposed skin. Use a hat to keep your head cooler in the sun and warmer in the cold. Bring along a rain poncho or even garbage bag if wet weather is possible. Wear layers so that clothing can be adjusted according to changes in temperature through the day (or elevation).

Dress appropriately. Hiking boots provide better ankle support than sneakers on uneven terrain. Helmets are important for high-speed activities like biking, riding ATVs and snowmobiling. Neckerchiefs come in handy for covering skin, getting wet to put around neck to cool down, or to wash or bandage wounds.

General Safety. Always be sure that someone knows where you are going and how long you plan to be away. Carry a flashlight and matches. Carry a cell phone (even if you don’t have service, the phone can often be tracked if you get lost). Always go with a buddy. Back away from potentially dangerous animals while facing them and making a lot of noise.

The Community Health Fair is Saturday, May 12, from 9 am to noon. Stop by our Mountain Trail Safety Clinic. I will be there to answer First Aid questions and give you tips on how to make a Basic First Aid Kit. We live in a beautiful part of the world. Enjoy it – Safely.


Susan Layeux, MD is a Primary Care Physician at Boundary Community Clinics and Chief of Staff at Boundary Community Hospital.

Prescription for Wellness: Advance Directives

Prescription for Wellness from Boundary Community Clinics


Start the Conversation about Advance Directives

By: Janet Lukehart, FNP-C

Healthcare decisions can often be complicated and confusing even under the best of circumstances. Unexpected medical issues and emergencies may place you in a situation where you are unable to speak for yourself, leaving your family to make heathcare decisions for you. Under these circumstances, how will your family and medical providers know your preferences for life-saving efforts and treatment? This is where an Advance Directive comes in.

Stated simply, an Advance Directive shares your healthcare wishes, should you become incapacitated and unable to express yourself. You specify the medical treatments you would want provided or withheld, and designate who is permitted to make these medical decisions on your behalf. Most people decide their preferences based on personal values and conversations with loved ones. Should you change your mind, updates can easily be made by submitting a new form.

Three types of advance directives legally recognized in Idaho are the Living Will, the Durable Power of Attorney for Healthcare, and the Physician Orders for Scope of Treatment (POST). A Living Will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, and related decisions such as pain management or organ donation. In the absence of an advance directive, medical care providers are obligated to prolong your life, using artificial means if necessary. With a Durable Power of Attorney for Healthcare, you name the person who will make these decisions for you when you are unable. The POST replaces the traditional Idaho Do Not Resuscitate form and is a set of medical orders you ask your doctor to write. The POST is most applicable for those with terminal conditions.

The Advance Directive process need not be complicated nor expensive. Instructions and templates for advance directives are combined in a free document provided by the state of Idaho. Idaho also maintains an Advance Directive Registry. By filing your document with the registry your healthcare provider and loved ones will have ready access to your directive in a time of need. Visit for more information. Other free and low-cost resources are available at, and

If you do not already have an Advance Directive and would like more information and/or forms, please stop by the Start the Conversation about Advance Directives exhibit area at the Hospital’s Annual Health Fair on May 12, 2018. Your actions now might well save your family members stress and emotional turmoil in the future, and assure your healthcare choices are met.

Janet Lukehart is a primary care Nurse Practitioner at Boundary Community Clinics.

Prescription for Wellness: April is Autism Awareness Month

Prescription for Wellness from Boundary Community Clinics

April is Autism Awareness Month

By: Beverly J. Yercheck, ANP-C

To highlight the growing need for concern and awareness about autism, the Autism Society has celebrated National Autism Awareness Month since the 1970s. This is a good opportunity to promote autism awareness, autism acceptance, and to draw attention to the many families facing an autism diagnosis each year.

What is autism?

Autism is a spectrum condition that affects individuals differently and uniquely to varying degrees. Many of the symptoms of Autism involve communication and socialization. Frequently those with Autism have problems with change, avoid eye contact, have facial expressions that do not correspond to the situation, have problems with personal space, appear to lack empathy and may avoid physical contact. Frequently these individuals have problems making and maintaining relationships.

How is Autism diagnosed?

Signs and symptoms typically appear in early childhood and can be diagnosed by a pediatric provider or by school specialists with input from family and friends. Signs that a child needs an assessment for Autism are usually noticed by the parents or primary care providers. These early signs may include the following: a baby that does not babble or coo by 12 months; a baby that does not gesture with waving or pointing by 12 months; a baby that does not speak even single words by 15 months or say 2 word phrases on his own by 24 months; or if there is any loss of language or social skills over time. These signs do not mean a diagnosis of Autism but they do signal a need for professional assessment.

Since Autism can look differently in each individual, it takes a team approach to put together a plan to help the child navigate in a “neurotypical” world. Success of the individual greatly depends on resources and support within and aside from the family. The school system can assist with interventions to help bring out the best academically and help develop social skills. It is important to remember that the individual with Autism has all the same needs that non-Autistic people have, they just express those needs in different ways.

Bev Yercheck is a primary care adult Nurse Practitioner with Boundary Community Clinics in Bonners Ferry.


The Autism Awareness Ribbon — The Autism Awareness Puzzle Ribbon is the most enduring and recognized symbol of the autism community in the world. The puzzle pattern reflects the complexity of the autism spectrum. The different colors and shapes represent the diversity of the people and families living with the condition. The brightness of the ribbon signals hope — hope that through increased awareness of autism, and through early intervention and access to appropriate services/supports, people with autism will lead full lives able to interact with the world on their own terms. – Autism Society