County’s poorest face pain of cuts

Some of Clark County's poorest residents may soon feel the effects of state lawmakers' budget trimming, especially those who need medical care or are on the brink of becoming homeless.

Hospital and social service officials say the biggest loss will come when the state siphons all the money from this year's $25 million indigent accident fund to meet a $341.7 million shortfall in the current state budget. Diverting that money will leave University Medical Center with $13.5 million less to treat impoverished patients injured in car accidents or stricken with catastrophic illnesses.

The ultimate impact was unclear Tuesday. UMC has already cut an array of services, including its oncology clinic, to offset an $8 million reduction in Medicaid funding.

"We can't rule out the possibility there might be further cuts to service lines," UMC spokeswoman Tammy McMahon said.

Nancy McLane, the county's social service director, said it might be possible at least to postpone the cuts. Mike Willden, state director of Health and Human Services, suggested that the state put off paying the indigent medical bills until the fiscal year ends in July, McLane said.

Fresh funding for the indigent program will kick in when the new fiscal year begins, enabling the state to pay the bills, McLane said. The program is set up so that hospitals treat the patients and bill the state, she explained.

The state pays for an accident victim's medical costs in full and helps the county pay for catastrophic care, she said.

Kathy Silver, UMC's chief executive, questioned whether deferring medical bills is feasible in the long run.

State lawmakers will grapple with a more severe budget crisis next year and could scrap the indigent program, Silver said. The county would have to offset the funding loss either by slashing services or throwing more into the hospital to curb its growing debt, she said.

"It just doesn't get absorbed into the floor," Silver said.

A less severe funding cut could affect poor residents quicker and more directly, McLane said.

The county lost the $400,000 it had left in this year's low-income housing trust fund, leaving no money to aid those who are struggling to keep a roof over their heads, she said.

Without that aid, several hundred families probably will wind up homeless, she said. "I don't have an alternative to offer. I don't know that there is one."

Last fiscal year, the program aided 2,030 households, adding up to almost 6,000 residents, she said. Since then, the economy has worsened, putting more people at risk of being destitute.

A homeless advocate called the reduced funding short-sighted.

"Eventually when you tighten everything, you're going to hang somebody," said Linda Lera-Randle El, founder of the group Straight from the Streets. "We're overrun with homeless people now. It's not a frivolous program."

The county also must pay $1 million it owes on insurance premiums for residents who qualify for both Medicare and Medicaid, McLane said.

Although the debt is legitimate, the state suddenly sprang it on the county, so no money was budgeted for it, McLane said.

Fortunately, agency heads had increased the budget this year because they anticipated growth, she said. That should give them enough money to cover the unexpected cost.

If the state slices deeply into its budget as expected next year, it would slash $15 million from the county's social services, McLane said.

"That would be significant," she said.

Contact reporter Scott Wyland at swyland@reviewjournal.com or 702-455-4519.