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State measure could force closure of UMC, county says

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Tiffany Brown

University Medical Center, which is Clark County’s only publicly funded hospital.

Updated Tuesday, March 31, 2009 | 4:01 p.m.

Beyond the Sun

A state Senate bill that would gut University Medical Center’s reimbursement for providing hospital care to poor people could force the county’s only publicly funded hospital to close, Clark County Commission Chairman Rory Reid said Tuesday morning.

But Charles Duarte, administrator for Nevada Medicaid, said Tuesday afternoon that the bill’s intention is to bring the state in compliance with federal law and to instigate discussion about indigent reimbursements, a “very contentious” issue for publicly funded UMC and private hospitals.

“We are working with Clark County to amend the bill in a manner that doesn’t harm UMC and the county to any great degree but at the same time contributes to hospitals that have been uncompensated,” Duarte said.

The state is violating federal rules, he added, by failing to reimburse some hospitals that provide care to the indigent.

The bill, SB 382, was characterized much differently to a special meeting of the Clark County Commission Tuesday morning, held as a budget primer as the county starts to figure out how it will pay for 2009-10.

Much of the talk focused on Clark County’s contribution to Nevada’s Disproportionate Share Hospital fund. Last year, the county gave $60 million to the fund. The state used that money to win federal matching dollars, effectively turning that $60 million into about $107 million. Most of that money is used to pay for indigent health care.

In return for its $60 million, the county got back $78 million after the state received the matching funds.

The bill that spurred the county’s ire reduces Clark County’s return to $33 million. The remainder would go to private hospitals to fund their own indigent care. Sunrise Hospital would get $16 million, Valley Hospital $5 million and Spring Valley Hospital about $3.5 million.

That scenario led Clark County finance director George Stevens to envision a future where UMC, which operates the only Level 1 trauma center in the county and its only burn unit, might close “because I don’t see where we could make up that $45 million.”

County commissioners had another idea: Just stop giving the $60 million to the state.

“Why would the county give away $60 million when that giving is going to ensure the death of UMC?” Reid said.

SB 382 was pushed by lobbyists for private hospitals who “would like to see UMC disappear,” one county official said.

Private hospitals argue that they care for indigents just like UMC and should be compensated for it because they are taking some of the burden away from UMC.

Clark County is, by statute, only required to fund indigent care “to the tune of about $15 million,” a top county official noted.

“So let them push this bill and get it passed,” he said. “Then the county would pay its $15 million, be done with the hospital business, save more than $100 million a year and let the private hospitals take care of indigents.”

But Duarte said the county and officials from UMC , as well as private hospitals, are in talks with his office to “have a healthy discussion about what the state’s health policy ought to be.”

“In committee meetings (in the Legislature) we stated many, many times in testimony that this bill is a strawman, because we had so little time to work it out,” Duarte added.

If some version of the bill passes, Duarte said it will have some effect on the amount of money Clark County gets back from the state. That is yet to be worked out, he said, adding that “there is no intent to harm UMC or close UMC or harm Clark County.”

Joe Schoenmann can be reached at 455-6175 or at [email protected].

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