NEVADA: County Seeks Federal Dollars Independent of State
In a "bold" and unusual move, Nevada's Clark County is asking for state permission to apply independently for federal dollars to support a program for county residents who "make too much money" to qualify for Medicaid. Bill Hale, CEO of University Medical Center in Clark County, is pushing for between $10 million and $30 million from the federal government to support a "county- organized health system," the Medically Needy Program. According to a new report, the county's hospital in FY 1997 paid $10 million to care for employed patients with insufficient health insurance who did not qualify for Medicaid. The county hospital lost an additional $30 million in FY 97 to "uncollected indigent care." Hale said, "The federal funds are out there, ready to be matched. My recommendation would be to have the county take this over."
How Do Medicaid and Check-Up Fit?
The Las Vegas Sun reports that the proposed Medically Needy Program would also place control of state Check- Up and Medicaid programs under county authority. Both programs receive federal matching funds: in FY 98 Nevada put up $173 million to get $267 million in federal Medicaid funds. And for FY 1999-2000, the state allocated $4.7 million for an $8.7 million federal match for Check-Up, aimed at providing insurance for 10,000 poor children.
Hale proposes to put a nine-member board in charge of the program: seven county commissioners and two governor's appointees. The board would form advisory councils from local social services and medical groups. State Assemblyman David Goldwater (D) says he is working on legislation to permit the county to pursue its plan. He said, "It's an innovative program. I think we will be able to access the federal dollars through the county system," Goldwater said (Nadler, 2/1).