Thursday, Oct. 2, 2003 | 11:03 a.m.
The region's largest hospital would have to balance fiscal, medical and social realities under a set of recommendations formally passed to the Clark County Commission on Wednesday.
The University Medical Center Task Force, a citizens' group established nine months ago by the commission following fiscal turmoil at the hospital and associated urgent care centers, unanimously passed the recommendations during a short meeting. The recommendations will go to the commission for discussion and likely action Tuesday.
The financial situation of the medical system, which is run by Clark County, had deteriorated so much that in December the commission was forced to provide $38 million to keep it afloat. UMC and the Urgent Care centers had faced an influx of indigent and uninsured patients over the last two years.
The situation has improved, with the monthly loss trimmed to less than $1 million in June. County officials credit new policies, recommended by the task force in March, that more aggressively seek payment information from patients. County staff said they would recommend that the commission pass the entire package produced by the task force.
"This is not the end. This is the beginning," Assistant County Manager Virginia Valentine said after the task force meeting. "We need to make sure that this is not something that goes on the shelf, collecting dust."
The task force produced a matrix for evaluating future service adjustments -- including, potentially, cuts. County Manager Thom Reilly said the recommendations would add a formalized, predictable process of evaluation to decisions to be made by the commission in the future. It would take into account social and fiscal needs, he said.
On the potentially volatile subject of the Quick Care centers, two of which were closed last year by the county as a cost-saving measure, the task force recommended that the county continue to operate the system. Before any changes are made to the centers, the group recommended studying how those changes would impact the fiscal, social and health care situation of both the hospital and the community.
The task force also recommended a number of areas for further study, including analysis of the tricky areas of paying for care for the truly indigent and malpractice insurance to draw some kinds of elective surgeries to the hospital.
The few observers who attended Wednesday's public meeting were cautiously optimistic.
"I think many of the recommendations will help," said Dr. John Ellerton, an oncologist in private practice and chief of the UMC medical staff, an elected position representing the professionals working for the system.
"It's important that they have created an analysis of what goes on from the financial side," Ellerton said.
He said his group and others will closely study the recommendations over the next six days.
Members from the union working for the county's medical system also said the task force suggestions appeared to be good ones.
"The recommendations you've made should improve UMC's financial situation without limiting access to health care for our community's most vulnerable," said Nick Ritz, a licensed practical nurse at the Spring Valley Quick Care.
Ritz warned that the number of Quick Care patients is dwindling and that means that the number of paying referrals to the main UMC are probably decreasing as well. He also told the panel members that staffing needs are paramount if the hospital is to remain a source of quality health care. He urged the county to address the issue of sometimes long waits for care at the urgent-care centers and the hospital.
"By ensuring that patients are seen by an appropriate number of trained staff and in an efficient manner, we can reduce the number of walkouts, treat more patients, and improve UMC's bottom line," Ritz said.
Several participants in the task force warned that despite the progress in stabilizing and improving UMC's financial situation over the last nine months, there are no easy or quick fixes. Bobbette Bond, a representative of the culinary union, said national and local medical systems have been hit hard by the growth in the number of uninsured patients.
"As long as we have this uninsured problem, this is going to be a recurring issue, nationally and locally," Bond predicted.
Reilly told the task force that the challenges facing the local system are not unique. A recent Wall Street Journal article said hospitals in Galveston, Texas, are rationing access to health care, cutting off those who are most likely to die.
And in Maricopa County, Arizona, the public health system is losing $2 million a week, Reilly said.
William McBeath, president of the Mirage and chairman of the task force, occasionally sparred with Bond during group discussions. But he said the end product represents an unusual degree of consensus among the 10 participants, who represented health care advocates, business and management, labor and other stakeholders.
"I'm glad we heard what at the time seemed to be diametrically opposed views," McBeath said. "It was a process of exchanging views when you have a makeup so diverse. They really were about compromise."
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