WestCare’s detoxification center in Las Vegas, which had been under threat of imminent closure, will remain open at least through the end of the year after Clark County commissioners voted Tuesday to fund the service for addicts aiming to shed their drug habits.
Commissioners also voted 6-1 to pay a portion of the $1.5 million WestCare said it needed to maintain operations in the 2018 fiscal year, ending June 30. Commissioner Marilyn Kirkpatrick cast the sole vote against both motions.
In addition to providing funding for the sole detoxification center in the Las Vegas Valley, the commissioners instructed county staff to explore opportunities for other mental health providers to address the need for such services.
“I look forward to the next model. I think it’s going to be comprehensive and it’s going to be better for our community,” WestCare spokesman Bob Vickrey said after the meeting.
The agreement came about two weeks before the threatened closure of WestCare’s detox facility at 323 N. Maryland Parkway after local governments, hospitals and the state stopped making payments to the national nonprofit. That raised concerns among mental health experts that the facility’s closure would overwhelm hospital emergency rooms.
Contract expired in 2016
WestCare said it continued to offer services to its clients after an “interlocal agreement” with the three entities expired on July 1, 2016, in anticipation of a renewed contract, but no agreement was ever reached. In the meantime, Clark County staff audited WestCare and determined that it owed the county about $1 million for services already covered by Medicaid.
Clark County Assistant Manager Kevin Schiller said at Tuesday’s meeting that the City of Henderson and local hospitals agreed to contribute funding to WestCare for the current fiscal year and the first six months of the next. The commission instructed staff to work with the cities of Las Vegas and North Las Vegas to devise an equitable funding split.
City of Las Vegas staff said in an April email that funding dedicated to WestCare’s detox center was redistributed to other projects surrounding homelessness after the contract lapsed.
According to WestCare, its uncompensated care rate — the percent of services not reimbursed by Medicaid or other insurance providers — is 47 percent. That amounts to a cost of $430 per bed per day that the state-certified triage center needs to recover to stay afloat.
Schiller said he has no way of verifying those figures.
WestCare has also inconsistently reported some figures and been unable to produce others. At the county’s May 1 meeting, representatives said the detox facility faced a 40 percent recidivism rate. At Tuesday’s meeting, that number was given as 30 percent.
It also couldn’t provide commissioners with an daily cost per patient at Tuesday’s meeting.
Pursuing long-term solutions
Still, the county will rely on WestCare’s figures to fund the center while it considers longer-term solutions, including attracting additional providers to offer detox services in Las Vegas and restructuring WestCare’s business model to account for services reimbursed under Medicaid. Schiller said two mental health providers have applied for licensure with the state and another two have expressed interest.
WestCare also said it believes its reliance on funding from the interlocal partners will lessen in the coming months with a state Medicaid enrollment coordinator now working on-site five days a week, which it anticipates will reduce its uncompensated care rate.
WestCare CEO Dick Steinberg suggested to the county commissioners Tuesday that the detoxification model be reevaluated by the county for efficacy in keeping drug users from relapsing, which he said was last discussed in 2002.
“There’s not been a committee to even address that or how it’s working in all these years, and I would suggest … that others would come back and really look at what ought to go into these systems,” Steinberg said.