Health care for kids traveling all over the MAP

Friday, March 29, 2002 | 3:13 a.m.

Kids Clinics

The clinics funded in part by the $1.5 million Making Access Possible grant:

WEEKEND EDITION

Recently, the Clinic on Wheels Adolescent Mobile Clinic stopped in a poor Las Vegas neighborhood, and a woman brought in a child who was complaining about chest pains.

The doctor diagnosed the child with a serious heart condition. Although the family had no money and no insurance, the child was taken to a local hospital and received surgery that saved his life.

On another occasion, a tourist from England had a sick child and was referred by the hotel to the Kids Healthcare Clinic on Maryland Parkway. The child was diagnosed with meningitis and was walked by the doctor across the parking lot to Sunrise Hospital and Medical Center, where he received lifesaving care.

Those were two of the more serious cases involving 5,000 children treated in the last two years at five clinics funded by "Making Access Possible" (MAP) in Nevada. The United Way of Southern Nevada says the $1.5 million grant it received two years ago to start the program has returned real human dividends, especially in providing health care to children of the poor.

"About 60,000 children in Nevada have no insurance, and many of their parents either take them to area emergency rooms for nonemergency treatment or, worse, take them to a doctor after the kids become seriously ill," said Xan Weir of the United Way of Southern Nevada, who helped set up the agency's partnership with four local pediatrics clinics in Las Vegas and one in Reno in January 2000.

"This program has been vital in reducing the overcrowding of our emergency rooms, like what happened last month with many hospitals diverting patients because their emergency rooms were overfilled, and in serving the large underserved pediatric population," he said.

MAP uses residents and students of the University of Nevada School of Medicine, local physicians assistants, nurses, dentists and other health care professionals to keep area pediatric clinics open into the evening hours or establish clinics in rural areas, such as Happyland Pediatrics in Pahrump.

Patients pay on a sliding scale based on their income, and in some cases there is no charge. Children generally are treated for earaches, infections, colds, flu, toothaches and other ailments of a non-emergency nature. Treatments cost the program about $84 per patient visit compared to an emergency room visit that can cost Medicaid or other insurers $175-$500, Weir said.

Dr. Bernard Feldman, chairman of pediatrics at the University of Nevada School of Medicine, said the program has enabled operations to be extended to 8 p.m. daily.

The School of Medicine has 12 of its medical students a year staffing the Kids Healthcare Clinic and the mobile clinic and provides residents and faculty to oversee their diagnoses and treatment plans.

"By having the funding to stay open later, we can see 30 more children a day," Feldman said, noting that while some are poor and are treated under the program, many others are paying customers whose parents find it convenient to take their sick children to the clinic at night after work.

Still, he said, "extending care to the underserved population is a passion of mine. It is important because not only does it give our doctors more training for treating a wide range of pediatric illnesses, it also teaches them about the need to treat poor patients for when they set up their own practices."

Dr. Rob Rollins, 35, is in his second year of residency at the University School of Medicine and has worked both at the Maryland Parkway clinic and on the Clinic on Wheels mobile unit, and says he enjoys going into the field to work with the poor who benefit from the program.

"It's like being the lone ranger -- you have to rely on your exam skills -- it's really hands on with no X-ray and no lab," said Rollins, who plans to one day be a pediatric cardiologist.

"And the best thing is that the people we serve on that bus really need the care. They are sometimes homeless or afraid to go to the hospital because of their immigration status. We don't ask questions. We just treat them."

Rosemary West, director of grant development for United Way of Southern Nevada, recently submitted the grant request for $2 million to keep "Making Access Possible" going another two years.

The money she is seeking comes from Nevada's share of the tobacco settlement, via the Task Force for the Fund for a Healthy Nevada. The $1.5 million to start the program was the largest grant from Nevada's tobacco settlement fund.

"This program really exemplifies what that money was intended to be used for -- tobacco companies paying to improve health," West said.

In addition, she said, the children who go to the clinics through the program are referred to Nevada Check-Up, which provides a family of four health insurance for as little as $10 every three months. And that further relieves the burden on the taxpayer.

Shelley Chapman, administrator of pediatrics for the University of Nevada School of Medicine, who oversees the operating costs of the Kids Healthcare Clinic, said dramatic increases in the numbers of poor people getting insurance have been realized through the program.

"When we started (with the program) about 28 percent of patients had no insurance, but in the last quarter, that has been reduced to 8 percent," Chapman said, noting that about 41 percent of the clinic's business comes from the grant.

Feldman said the current malpractice insurance crisis is not expected to hurt the program, even though it has been reported that medical school doctors face losing their malpractice insurance by this summer because of the pullout of the St. Paul Cos. from that line of coverage. He said four offers are on the table for the school's pediatric doctors and one will be chosen before the old coverage lapses.

The Adolescent Mobile Clinic will be in the parking lot of United Way, 1660 E. Flamingo Road, on April 4.