Medical center cuts anger seniors

Cost-saving measures at the Community Health Centers of Southern Nevada's local senior citizen medical center have angered several regular patients and some state administrators.

Ken Moore, chief executive officer of the nonprofit centers, last month replaced a full-time physician with a physician's assistant and cut office hours from five days a week to two days at the Cannon Senior Center Medical Clinic, 340 N. 11th St. He had no other choice, he said, because the state reduced his budget by $1 million.

Moore said Nevada's switch to Medicaid managed care caused the financial dilemma. In October, the state required that Medicaid patients abandon a fee-for-service system in which they selected a doctor of their choice in favor of health maintenance organizations.

Laurie England, chief of the state's Medicaid Managed Care office, said she couldn't substantiate whether Moore had $1 million less in his budget, but no money has been taken away all at once.

Now, Moore said, two HMOs manage the Medicaid money, which means his organization gets $70 less per person who seeks service at the two centers at 916 W. Owens Ave. and in Henderson at 67 E. Lake Mead Drive.

He estimates the $1 million loss in revenue based on that change.

The West Owens Avenue clinic mainly handles indigent and homeless patients, Moore said. Their bills are paid through Medicaid and federal indigent and homeless programs.

The Henderson clinic also services the homeless, he said, and receives funding through the same three sources, plus walk-in patients who have private health insurance.

Most of the senior citizens who seek medical treatment at the Cannon Center are on Medicare, Moore said.

Charlotte Crawford, director of the state Department of Human Resources, said the Medicaid managed-care law was never meant to affect senior citizens, most of whom are on Medicare or have chosen to join a Medicare HMO. It pertains only to people on welfare and pregnant women with children who meet certain income guidelines.

However, Moore said, the revenue from the Owens Avenue and Henderson clinics was subsidizing the Cannon Center. The loss of Medicaid money forced him to make cutbacks at all three clinics.

"We were picking up the losses at these sites," Moore said. "This forced my hand to look at each site."

Besides reducing the hours at the Cannon Center, Moore let 15 employees go at the West Owens Avenue center and reduced hours of operation in Henderson.

Moore said he is in the process of determining how much money each center has been losing.

"Any company that loses a fifth of its revenue has to rethink its spending," Moore said. "We are doing what's necessary to deliver care.

"You don't want to take services away, but how do you pay for them?" Moore asked. "We want to talk to the Legislature to see if they can help us with the state Medicaid program."

Sen. Raymond Rawson, R-Las Vegas, chairman of the Legislative Committee on Health Care, says he is perplexed by Moore's decision to involve the Cannon Center in Medicaid issues. The new Medicaid law, he said, exempts seniors, the blind and disabled individuals.

"We never intended this to happen," Rawson said. "This should not be an issue. We (the Legislature) may have to get involved."

Rawson said if the Cannon Center can't provide adequate medical care for seniors, he may recommend that a University Medical Center Quick Care be located inside the facility.

Dr. James Laird, the physician who was fired, said Moore did it to save money.

"I had a nurse and medical aide, and we were seeing 17 to 20 patients a day," Laird said. The physician's assistant "doesn't have the experience to be a geriatrician. These people want a doctor who will spend time with them."

Patients agreed they want more time and attention from providers at the clinic.

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