Subsidy for UMC outlined

University Medical Center needs $41.4 million from taxpayers to sustain operations this upcoming fiscal year, Clark County Manager Virginia Valentine told commissioners Tuesday.

That budget figure nearly triples what hospital administrators have sought in previous years, and it already includes the elimination of 50 vacant positions, cuts in overtime pay, a reduction in the use of temporary staff and renegotiation of some supply contracts.

UMC’s proposed 2008 budget, which will be officially presented to the commission on Monday, includes retaining 10 programs and services recently singled out by hospital administrators for possible closure.

“This figure is higher than we would like it to be. But it should be noted that the Lewin Group showed us this level of support is below that of other major public hospitals,” Valentine said about UMC’s proposed budget.

“We continue to look for additional ways to reduce costs through increasing operational efficiencies. We also have begun a public outreach process to help us further evaluate programs and services.”

The Lewin Group is a health care consulting firm hired by the county to study options for UMC.

Last month, UMC administrators announced that Southern Nevada’s only public hospital faces a $53.7 million budget deficit for 2008. That figure already included a $6.3 million cut due to a reduction in the use of temporary staffing and a reorganization of work schedules to eliminate overtime.

UMC administrators further cut the projected level of support by $12.3 million by eliminating some vacant positions, renegotiating supply contracts and renegotiating or eliminating some purchased services.

Those reductions leave the hospital needing $41.4 million.

To trim the budget further, administrators listed several services they said warranted a review for possible closure. They included the pediatric endocrinology clinic, neonatal intensive care unit, HIV Wellness Center, Family Resource Center, several Quick Care centers, the Lions Burn Care Center, the Searchlight Clinic and some rehabilitation services.

Cutting all of those services could trim UMC’s budget deficit to $27 million, but taking away specialty care services from the public has sparked heated discussions in recent weeks, and the public has voiced its displeasure to commissioners.

On Tuesday, Valentine said there would be no recommendation to close the Lion’s Burn Care Center because it is the only one in the state.

Regardless of what decisions are made on remaining programs and services, the McCarran Quick Care center will close by October 2009. Expansion at McCarran is forcing the Quick Care off premises.

“These are valuable services, and they are all services that are above the county’s statutory mission, which is to provide care for the indigent,” Valentine said.”In some cases, this coming discussion could lead to reductions in service or programs. In other cases, this could lead to more public-private partnerships.”

Last week, Kathy Silver, UMC’s chief executive officer, said the evaluation of services and programs is expected to take at least 60 days and will include focus group discussions with hospital employees, physicians and management, and community stakeholders.

The University of Nevada School of Medicine will also be involved, Valentine said.

The first focus group, which will be comprised of hospital staff, begins next week.

Public meetings have not been scheduled yet but will be held within the next 60 days, Valentine said.

“These are extremely tough times,” Commissioner Lawrence Weekly said after listening to Valentine’s report.

Weekly said he hopes the discussions will include opportunities to create partnerships with other agencies.

For example, he said, the county might want to have conversations with the Southern Nevada Health District about UMC’s HIV Wellness Center, since the district deals with communicable diseases.

“I just want to make sure the conversations are happening,” Weekly said.