State health budget trimmed

Despite a 4 percent injection into its overall budget, the Nevada State Department of Health and Human Services still faces some challenges in the next two fiscal years.

The department’s case load continues to increase and its Medicaid program is set to significantly lower what it pays hospitals and other health care providers.

Those Medicaid cuts could lead to closures of some rural hospitals, delays in care to the sick, emergency room overcrowding and the elimination or reduction in services at for-profit hospitals as health care providers try to balance their own funding shortages, health officials and lawmakers say.

Add to that a shifting of the state’s Indigent Accident Fund dollars — about $55 million — from hospitals to bolster the Medicaid program and Nevada’s health care system appears in dire straits.

“I don’t believe we’re going to be able to implement further cuts to Medicaid without the system collapsing,” said Assembly Speaker Barbara Buckley, D-Las Vegas. “Abused children are not getting served. Kids with heart problems are not getting operations. We’re going to have to come up with better solutions. … We have to go in another direction.”

Buckley’s comments came during a legislative hearing to review the department’s budget and to discuss Gov. Jim Gibbons’ proposed $6.17 billion budget.

That budget is $1.8 billion short of the projected $8 billion that the administration maintains it would need to keep spending at the levels contemplated when the Legislature adjourned in June 2007.

The Legislature convenes Feb. 2.

The department’s budget represents $2 billion of the state’s budget, which is an increase of 4 percent, or $81 million, from fiscal year 2008-09.

Despite the increase, department director Mike Willden said the state agency will lower Medicaid reimbursements to hospitals and other health care providers by 10 percent in the upcoming fiscal year.

Lawmakers also expressed concerns about a proposal by the state’s Spending And Government Efficiency commission to allow funding from the Indigent Accident Fund and Supplemental Income Fund to go toward Medicaid.

Willden told lawmakers Friday that the money would be shifted to the Medicaid program so the state can qualify for an additional $60 million in federal matching dollars. However, Bob Hatfield, a lobbyist for the Nevada Association of Counties, said area hospitals are going to be hurt without those dollars.

“If you eliminate this fund you’re going to have other impacts,” he said. “Hospitals are going to have to charge more to paying patients and counties are going to have to go bankrupt to pay these bills.”

Currently, those funds are used only to support medical care for indigents involved in auto accidents. The funding comes from county property taxes and brings in roughly $55 million, Willden said.

Contact reporter Annette Wells at or 702-383-0283.

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