Prenatal care options in works

The University of Nevada School of Medicine's obstetrics and gynecology department will provide prenatal care to women who ordinarily would have been eligible for University Medical Center's Women's Center. But its not yet clear just how many of those women the medical school will be able to handle, said Dr. John Hazen, vice chair of its obstetrics and gynecology department.

Nevada Health Centers, the other safety net UMC named as an alternative for poor and uninsured women to obtain prenatal care, is in a similar situation. The nonprofit health care provider plans to assist as many women as it can. However, capacity, work force and finances are issues, officials say.

"The bigger challenge is the financial burden being shifted, not cured,'' said Dr. Carl Heard, interim chief executive officer for Nevada Health Centers. "UMC is doing everything it can, but it has reached its limit with certain services. And we're going to do everything we can, but with such short notice, it's going to be difficult. ... Unfortunately, we're always asked to help when no one else can.''

Hazen said because the School of Medicine didn't hear about UMC's plan to drop prenatal services at its Women's Center until the day it was announced at last month's Clark County Commission meeting, plans to transition these women into the system are still being ironed out.

During that meeting, UMC administrators pitched more than a dozen services to cut as a result of the state's struggling economy as well as lower Medicaid reimbursements.

Medicaid provides some medical care to the poor.

Kathy Silver, the hospital's chief executive officer, said one of the reasons those particular services were chosen for cuts is because they are offered elsewhere throughout Southern Nevada.

However, days after the announcement, some health officials have said it is uncertain where people, especially the uninsured who do not qualify for Medicaid or Medicare, would obtain health care if private providers aren't willing to take on the burden.

UMC's Women's Center provided prenatal care to 700 women.

"We don't know how many of the 700 we will be able to take on because this was kind of dropped on us all of a sudden,'' Hazen said. "We're just taking one day at a time.''

Heard and Hazen said they are having daily discussions with UMC to transition patients.

The medical school, which operates a clinical practice known as the University Health System, will monitor patients' pregnancies and determine whether they have any other health problems such as high blood pressure or diabetes.

The babies will be delivered at UMC, Hazen said.

University Health System has more than 300 doctors that practice and teach throughout Nevada in more than 40 medical specialties.

"We are tapping into the Clark County OB/GYN Society to see if there are any physicians who can take care of patients with other needs because county facilities are no longer available,'' Hazen said. "It's going to be a huge challenge for us.''

Heard said Nevada Health Centers is also making contact with the Clark County OB/GYN Society as well as the state's medical association for help.

Hazen said private practices aren't as willing to take on patients who have no pay source such as insurance, or who wouldn't qualify for federal or state health programs.

The School of Medicine, he said, is currently trying to determine how it will be able to provide care to patients who don't have a medical pay source.

"There's a combination of plans we are trying to work through,'' Hazen said. "We're also looking at a tiered system for people who have reduced incomes. The goal is for them to pay a portion of their care. We can handle the prenatal care but we don't know what's going to happen once these patients need to deliver at UMC. That's not in our control.''

Heard said Nevada Health Centers is urging physicians in the community who can help to call the nonprofit at 307-5414.

Contact reporter Annette Wells at awells@ reviewjournal.com or 702-383-0283.