Carl Heard, chief medical officer of Nevada Health Centers

Steve Marcus

Dr. Carl Heard, chief medical officer of Nevada Health Centers.

By Timothy Pratt

Monday, Jan. 19, 2009 | 2 a.m.

As chief medical officer of Nevada Health Centers, the state’s largest network of clinics for low-income patients, Carl Heard is busy these days.

With Las Vegas’ unemployment rate at 7.9 percent, more than a point above the rest of the nation’s, an increasing number of people lack health insurance. Low-cost care is a vital alternative.

The nonprofit health centers have a $24 million budget, about a third of which comes from the federal government, and operate 28 clinics in Nevada, 16 of them in the Las Vegas Valley.

We caught up with Heard recently as he left a meeting about keeping track of homeless patients with computerized records.

Which of the recent cuts in health care services will most affect low-income patients?

For starters, the ones at (University Medical Center), including cancer care and the women’s center, the 14 percent reduction in the mental health budget and the fewer grant dollars, from tobacco settlement money, going to innovative health programs.

What are the implications?

Since we are already near the bottom of so many lists — percentage of eligible people using Medicaid, teen pregnancies, smoking, for example — we’re going to face even more challenges. The cuts are about the economy but they further highlight our lack of responsibility with the most vulnerable.

What do you think will be the outcome?

More deaths. This is where fiscal conservatism becomes socially irresponsible.

How is the economic situation affecting your clinics?

As people become uninsured, they demand more of our services. Six months ago, we used to be able to accommodate every woman seeking prenatal care with an initial interview within two days. Now it can take up to 10 days. The same could be said for our primary care. At the same time, some patients may forego seeking services in order to save money.

What can be done to fill in gaps in services?

We’re going to seek federal grants to begin offering mental health services, since so many of our patients have those needs, which may increase in tough economic times.

Is there any silver lining in this?

Well traditionally, fiscal conservatives say, “I’m a hardworking person and I don’t want all these poor people sucking money from my pocket.” But if things keep going the way they are, more people will see that it’s not us versus them. All of us are going to be challenged. It will be just “us.”