Fate of children’s hospital rests with voters

By Emily Richmond (contact)

Friday, May 18, 2001 | 5:01 a.m.

Carrie Beckstrand of North Las Vegas wishes her infant daughter could have been treated in Clark County when she needed specialized care because of heart problems.

Mikheala Beckstrand, now 5, has had six surgeries and numerous hospital visits. The family has traveled out of state to see specialists who don't practice locally and relies on friends and relatives to care for their other five children.

"It's more stressful on everyone when you have to take a sick child out of their comfort zone," Beckstrand said. "It also meant leaving the rest of our family behind."

Although Mikheala received excellent treatment at the University Medical Center's pediatric department, visits to the free-standing children's hospital at the University of California, San Francisco, highlighted the disparity, Beckstrand said.

Murals line every wall at the California hospital, and giant footprints guide visitors through the halls. Everything from the bathroom facilities to the waiting areas have been scaled to kid-size.

"Everyone we met, the doctors and nurses, would crouch down to Mikheala's level," Beckstrand said. "I can't begin to tell you what a difference that made for her emotionally."

UMC administrators are proposing a public children's hospital, which they say will attract some of the country's top specialists.

On June 5 Clark County residents can vote whether to approve an $80 million bond to pay for the project. The tax-neutral bond would not increase taxes, although it would prevent future tax cuts because it would replace retired bonds.

Beckstrand admitted that even with a children's hospital in Clark County, it's likely her daughter would still have to travel to San Francisco to receive the most-recent specialized surgery.

However, other families would certainly benefit from localized facilities, she said.

"There are parents who have to drive hundreds of miles to get their kids to the right hospital and wind up sleeping in waiting rooms, on cots, in their cars," Beckstrand said. "Maybe that would be acceptable if Las Vegas was some kind of Podunk town. But it certainly is not, at least in my mind."

If the plan is approved, UMC would build a 255,000-square-foot facility on its existing campus. The hospital would include 152 pediatric beds and an expanded neonatal intensive-care unit. To save money, the new facility would use the existing UMC commissary.

Clark County Commissioner Bruce Woodbury said he was skeptical of the plan until he saw the results of an Arthur Anderson study supporting UMC's projections for increased need, costs and potential earnings.

'Need-based proposal'

"This is a need-based proposal," Woodbury said. "All of our children deserve equal access to care."

Opponents say the money would be better spent on pediatric services not currently available or on programs that target a growing senior population.

If Minta Albietz was handed $80 million to spend for children's health services, the Sunrise Children's Hospital vice president said she would not build a publicly funded children's hospital.

Rather, Albietz said she would use the money to fill in serious gaps in pediatric services countywide. For example, Sunrise Children's Hospital has 144 beds -- including 54 in the neonatal intensive-care unit -- but no children's psychiatric ward.

"We had a boy come in here last week who tried to kill himself, and there was no place that could take him," Albietz said. "He's 13 years old, and all we could do was keep an eye on him at our emergency room so that he would be in a safe environment."

There are no plans for a psychiatric ward in the proposed public children's hospital, UMC administrative director Jackie Taylor said. But out-patient mental-health services will be offered.

The state's Division of Child and Family Services provides mental-health care for Clark County, including two residential facilities. Susan Mears, project coordinator for the state-run neighborhood care centers, said she would welcome a local children's hospital that includes a psychiatric ward.

"There are times when we're backed up, and it would help to have another option in the mix," Mears said.

Sometimes children in acute suicidal or homicidal states also have physical ailments that require treatment. Consequently, having a complete children's hospital adjacent to a psychiatric ward would save both time and energy, Mears said.

Supporters of the children's hospital don't deny that Clark County falls short in some social-service areas. They ask that the plan be considered on its merits.

"Whenever a plan is put forth to use public funds for a project, someone always has an idea how the money could be better spent," Woodbury said. "The reality is this is a need-based proposal that affects the quality of life for all of us."

Albietz, a hospital administrator for 25 years, said neither she nor her colleagues at Sunrise want to come across as "anti-UMC." And they also aren't afraid of competition. But Sunrise officials question whether UMC can build and staff a public children's hospital for $80 million.

Sunrise has been forced recently to divert pediatric patients to other facilities because of a nurse shortage, Albietz said.

"UMC isn't immune to the nationwide shortage," Albietz said.

Competitive salaries

Taylor said she is confident that nurses will flock to work at the children's hospital because of competitive salaries and the appeal of working in a dedicated pediatric setting. The hospital also could start with a built-in staff as nurses from UMC would transfer to the new facility.

Southern Nevada's booming population over the past 10 years has caused the number of pediatric patients treated at UMC to jump from 1,200 to 30,000 annually, Taylor said. The neonatal unit is set up with 28 beds, but at times -- particularly when other hospitals are on divert status -- there are as many as 40 babies, she added.

"We're the last resort for a lot of our patients," Taylor said. "But we can't expand our programs unless we have the space."

Sunrise officials scoff at the supporters' assertion that being a free-standing building is essential to a children's hospital's success.

"It has nothing to do with a building. It's your philosophy of care," Albietz said.

Katrina Bookrum was visiting her mother in Las Vegas when her 13-month-old son began running a high fever and had to be rushed to Sunrise Children's Hospital.

It didn't matter to Bookrum that her son was being treated in a part of the hospital that was a series of wings connected to the adult facility and not a free-standing hospital.

"The care has been excellent," Bookrum of Long Beach, Calif., said. "I'm just glad the doctors were here."

Hospital supporters say having a free-standing facility would allow pediatricians to implement a system of self-government, which would give them more say in how the hospital is be managed. At the same time, the children's hospital would benefit from discounts on bulk purchases because of its affiliation with UMC, George Stevens, Clark County's finance director, said.

Nevada ranks 46th in the nation with just 30 pediatricians for every 100,000 children. A children's hospital would help boost that ratio, said Dr. Meena Vohra, UMC director of pediatrics.

In 1999 1,945 children left the state to seek medical treatment, Vohra said. If a public children's hospital is built, that number could drop by as much as 90 percent.

Pediatricians around the country have called to learn more about the proposed hospital, Vohra said. "I tell them they have to wait and see how the ballot goes next month."

Three to five years

It would take about three to five years to build the hospital, during which time staff members and specialists would be recruited, Vohra said. Administrators are considering teaming up with the University of Nevada School of Medicine for resident training and are looking into federal research grants, she said.

"We're not going to become Boston Children's Hospital overnight," said Vohra of the more than 100-year-old institution that consistently ranks in the top three nationwide in pediatric care. "But we have to start somewhere and then strive to become better and better."