County to limit access to UMC clinics

Wednesday, April 2, 2003 | 10:55 a.m.

Some medical patients will have fewer options to choose from as of May 5.

The Clark County Commission, accepting recommendations from a citizens task force looking at the public health system's fiscal crisis, voted 5-0 Tuesday to restrict access to the county's Quick Care network for "self-pay," or uninsured patients.

The move will not affect emergency cases, county officials for University Medical Center said. But those patients who are not in an emergency and who do not prove they have insurance or the ability to pay will be directed to eight clinics around the county where they can receive counseling on how to enroll in federal or local benefit programs.

"If nothing else, they're seeing a physician before inquiring about these financial arrangements," UMC Chief Executive Officer Mike Walsh said. "I don't see a big difference in how we approach patients for emergency care."

But the chief executive of three nonprofit clinics where patients will be referred said the plan could backfire.

"A lot of those people could end up in the emergency room," said Steven Hansen, CEO for the Nevada Health Centers.

The move was expected. The County Commission in December was forced to pump $38 million into the health system, which includes 12 Quick Care centers and the main UMC hospital.

Under the new plan the county hopes that patients with non-emergency health problems will enroll in programs that ultimately bring in some revenue to the county or other clinics providing service.

The increase in non-insured and indigent patients after the Sept. 11, 2001, terrorist attacks and the subsequent economic downturn has been cited as the main reason for the hospital system's fiscal woes.

The eight clinics identified by the county include the Nellis, Spring Valley and Sunset Quick Cares. The county plans to have social workers available to help patients make financial arrangements at those centers.

The Enterprise Health Care and Dental Center, the Lied Ambulatory Care Center and the North Las Vegas, Martin Luther King and Cambridge Family Health Centers are the other sites recommended by UMC and approved by the county.

The clinics all receive a mix of federal, state and some local funding. Hansen, of the Family Health Centers, said he did not receive much advance warning of the move from the county.

"I hope I get a phone call," he said.

Hansen, whose clinics receive about a third of their funding from the federal government, said a tide of uninsured and nonpaying patients will not make the situation better for either the county or the general population.

He said the centers already have a two- to three-week wait for appointments.

"Instead of being a three-week wait, it will be a five-week wait," Hansen said.

The centers do have programs to sign up as many people as possible for federal assistance programs, he said. Getting paying patients into the centers is important for the Family Health system as well as for the county, he added. "The only way we can see more people is with more insured," Hansen said. "We have to have that balance, or we will be overwhelmed and we will go out of business."

He said the Family Health Centers in Clark County see 2,300 to 2,400 patients monthly, and those patients will turn to the county if the centers no longer provide care.

The move to direct self-pay patients is the latest in a series put in place by the county in response to UMC's fiscal crisis. Steps taken so far include some staff cuts and reductions in hours at one Quick Care. The citizens task force is considering more steps, which could include deeper changes to staffs, revamping the antiquated billing process and restricting some services.

Walsh told the commissioners during a budget workshop later Tuesday that without further overhauls of the hospital system, it would need $15 million more than budgeted for this year.