Las Vegas Sun

March 28, 2024

Clark County brings its wish list to Carson City

It’s so common for private hospitals to ship uninsured patients to public hospitals, there’s a slang term for what prompts the transfers: “negative wallet biopsy.” It means staff determined the patient can’t pay for care and therefore must be transported to a public hospital, which by law can’t turn people away.

For Clark County officials, though, such transfers are no joke. And they want the state Legislature to do something about them.

As part of their wish list for the upcoming session, county officials are asking Nevada lawmakers to enact stricter rules about how local hospitals transfer patients, to curb private hospitals’ practice of transferring uninsured or underinsured patients to University Medical Center. The measure would help UMC, which is publicly funded, reduce its operating costs by absorbing fewer losses from treating uninsured patients.

The request is among seven pieces of legislation being pushed by Southern Nevada city and county governments for the upcoming session. Another 10 bill draft requests have been submitted by county and city government associations. More bills will be put forward by legislators once the session begins.

Local government lobbyists are optimistic about the outcome with Sen. Pete Goicoechea and Assemblyman John Ellison at the helm of the government affairs committees in their respective chambers. Goicoechea served for 15 years as a Eureka County commissioner, while Ellison spent eight years as an Elko County commissioner, meaning they are familiar with the challenges and needs of local governments.

What valley governments want from the Legislature this session:

    • More autonomy

      One of the most persistent conflicts between state and local governments is over the concept of home rule. Several states, including Nevada, give nearly all major decision-making authority to the state government, a situation that long has frustrated local governments. Part of the complaint is that because the Legislature meets only every other year, local governments can be hamstrung making decisions while waiting months or more for state approval.

      Senate Bill 29, put forward by the Nevada Association of Counties, would carve out space for more local autonomy when decisions have to be made about public health and safety. Jeff Fontaine, the association’s executive director, said the bill is a good starting point for expanding local authority because it focuses on a narrow section of the law. Two other, more expansive home-rule bills also have been filed with the Senate and Assembly government affairs committees.

      In addition, North Las Vegas is pushing for more control with a pair of bills — Senate Bill 71 and Assembly Bill 64 — that would allow the city to amend its charter without legislative approval and enable the city council to make decisions previously left to the county commission.

    • Money

      State and local governments also clash about how to split the bill when it comes to providing services, with local officials bemoaning unfunded mandates passed down from the state.

      Two bills — Senate Bill 16 and Assembly Bill 10 — put forward by the Nevada Association of Counties aim to increase the share the state pays for pre-sentencing investigations for criminals, used to determine jail or prison sentences, and for providing legal representation for indigent criminal defendants, which costs Clark County tens of millions of dollars a year.

    • Hospital help

      Senate Bill 33, put forward by Clark County, would give UMC’s governing board the ability to meet behind closed doors when discussing strategy and business decisions. The bill would reduce public transparency, but officials argue it’s needed to keep sensitive information away from competitors.

    • Public records fees

      Local governments want to add wording to Nevada’s public records law to ensure costs are covered when fulfilling large records requests.

      The proposed law allows for governments to charge 50 cents per page for electronic records, a nod to the fact that most government records are stored electronically and can be transmitted by email or CD. The rate is the same local cities and counties can charge for physical copies.

      Governments also will be able to charge a fee “equal to the actual cost required for an employee” to fulfill the request.

      Both of the charges would apply only for large records requests that result in more than 25 pages returned or more than 30 minutes of staff time to fulfill.

    Join the Discussion:

    Check this out for a full explanation of our conversion to the LiveFyre commenting system and instructions on how to sign up for an account.

    Full comments policy