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April 20, 2014

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Hospitals postpone decision on funding of triage center

Area hospitals want time to crunch the numbers and look at WestCare's books to make sure they are getting the most for their money before voting on whether to provide the funds to keep the nonprofit organization's Community Triage Center open at least through March.

Richard Steinberg, president of the nonprofit group, said that's OK with him because at least 70 percent of the area's 12 acute care hospitals already are voluntarily providing monthly shares of funds to keep the center going, and he can wait a couple weeks to get the long-term funding commitment from every hospital. In fact, he said, the two St. Rose Dominican hospitals already have committed their annual funding shares.

The 16-member Clark County Health District Facility Advisory Board, composed of chief executive officers from all area hospitals plus other mental health care officials, took no action Monday on the plan that calls for the hospitals to commit $1.3 million of what now is a $2.7 million funding package for the 56-bed facility at 930 N. Fourth St. that treats chronic alcoholics and the mentally ill.

Instead, the hospitals' chief financial officers will review the funding formula and send their findings back to their bosses, who will gather for a facility advisory board meeting, possibly late this month or in early September.

"I believe the board is acting appropriately by taking this seriously and making sure the dollar numbers are right," Steinberg said after Monday's meeting. "They are not brushing us off.

"We will stay open, but we need this (hospital) commitment so that our operations can remain consistent, not so stop and go. It is difficult to keep staff because employees want to have some security that their job will exist longer than from month-to-month."

Original plans called for $3.8 million in annual funding for the triage center, split three equal ways between the hospitals, state and local government entities. But that had to be scaled back late last year when the state failed to come up with its share, which resulted in the local government entities holding back their fiscal 2005 shares in June in the wake of the state's non-action and the center's questionable future.

On July 1, WestCare threatened to close the facility that officials say relieves overcrowded area emergency rooms by treating 9,000 alcoholics, drug addicts and the mentally ill per year. However, $163,000 in emergency funds were pledged by the city of Las Vegas and Clark County to keep the center going through the end of this month.

Dan Musgrove, Clark County's intergovernmental liaison, presented to the board Monday a "Band-Aid" plan that, in addition to the money from the hospitals, calls for area cities and Clark County to release their $1.27 million share. Those entities are to vote on releasing the money at September public meetings. The state also is soon to decide whether to provide $428,000 from a federal grant that is funneled through the state.

"The goal now is to keep the CTC open until we get to the Legislature in 2005," Musgrove said, noting that some lawmakers intend to offer bills that will restore the state's share of funding for the triage center. "We need to make sure we (hospitals and local government entities) come in united."

Musgrove's funding formula requires hospitals to pay different amounts based on estimates of how much extra burden they get from alcoholics, drug addicts and mentally ill people in crisis. The funding package is based on $488 spent per-patient per day at the triage center.

However board members questioned why it cost WestCare just $399 a day for its temporary 28-bed operation at its Martin L. King Boulevard headquarters. For 3 1/2 weeks this summer those beds enabled WestCare to take in and evaluate mental health patients who initially went to emergency rooms.

Steinberg and Musgrove said it cost less to operate beds at the Martin L. King site because there already was support services in place for that operation which was a stopgap measure until the state opened its 28-bed addition at its main psychiatric hospital at 6161 W. Charleston Blvd.

Steinberg also said he would comply with the board's request to disclose the triage's operational costs on a monthly basis.

The triage center opened in January 2003 and is expected to treat as many as 7,200 homeless or indigent people this year -- patients who, county officials say, traditionally end up in jail or in hospital emergency rooms for evaluations to determine if they require a bed at the state mental hospital.

Last fall, in the wake of the state's failure to fund its share, WestCare officials cut about a third of the triage center's original staff of 60 and reduced the number of ambulances it uses from three to one.

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