TV news show highlights void in hospital care

The dire situation faced by cancer patients whose outpatient care was cut off by University Medical Center has been in the news locally for months, but state lawmakers are now scrambling to find a solution in the wake of a report by a national news show.

The CBS program "60 Minutes" put a national spotlight on the hospital, which canceled its outpatient oncology services Dec. 31 because of continuing budget woes. The loss of the clinic has left some patients with nowhere to go to receive chemotherapy treatment.

With Clark County residents losing their jobs to the recession, the number of patients going untreated is likely to increase. On Wednesday, members of the Committee on Health and Human Services heard testimony on a proposed bill, Assembly Bill 433, which would force county hospitals to provide outpatient cancer treatments to indigent patients.

"I watched that "60 Minutes" ... it's just unacceptable; people are dying," Assemblywoman Sheila Leslie, D-Reno, told hospital administrators. "How could you close down the clinic with no plan for these people? I could not have made that decision and lived with myself."

Kathy Silver, the chief executive officer of Clark County's hospital, said the decision to end outpatient care arose after Medicaid reduced reimbursement rates. UMC is already operating at a $50 million deficit; the reduction in reimbursement rates will add another $21 million in revenue losses.

Silver said the bill as written is too broad. More people could be defined as indigent as more workers lose their jobs. The middle-class was hit hardest by the cut because low-income residents are eligible for help from Clark County Social Services and wealthier patients can seek help from private clinics.

"The poor are getting care, the rich are getting care, the middle class are not," Silver said.

Many of Nevada's physicians cannot afford to take on oncology patients without reimbursement because the chemotherapy drugs can cost up to $12,000 per round.

Silver called the decision to end outpatient oncology services "gut-wrenching," but said administrators studied each of the hospital's programs and opted to keep services unique to UMC.

Oncology services could be provided by other facilities if they stepped up to help during the crisis, she said.

"There are clinics doing chemotherapy treatments all day long," Silver said. "They just aren't doing it on people who don't have insurance."

When it appeared the hospital would have to close the oncology clinic, administrators reached out to other professionals in the community. A clearly frustrated Silver told legislators that there was little interest in assisting with the problem.

"It was like one hand clapping," she said. "You can't make a lot of noise with one hand clapping."

The hospital is in talks with two private contractors that might eventually help restore services, but nothing has been determined, Silver said. "It's not that easy to do and it can't be done overnight," she said of resolving the crisis.

On Sunday evening, "60 Minutes" quoted a handful of cancer patients saying they had nowhere to go for treatment and felt like they were being left to die.

"There's a lot of people out there who are dying and we're just going to say 'We don't have the money?' " said Leslie, who said the "60 Minutes" show "haunts" her.

"This has got to be solved and I will help."

Legislators indicated they had been inundated with e-mails from taxpayers who believe they made the decision to cut the program.

The lawmakers made it clear they did not make the decision, nor would they have.

"We as a state cannot stand for this," said Assemblywoman Bonnie Parnell, D-Carson City.

Clark County's social services division has reached out to the patients interviewed on the show to help them find needed assistance, Director Nancy McLane said.

Wednesday was the second day the Assembly committee heard testimony on the proposed bill. No vote was taken after the hour-long session.

Contact reporter Adrienne Packer at apacker@reviewjournal.com or 702-384-8710.