Inspections of health centers in jeopardy

Nevada Human Resources Director Mike Willden told lawmakers Thursday he will have to lay off the employees charged with inspecting hospitals, clinics, surgery centers and other health facilities around the state unless they approve regulations setting the fees that pay their salaries.

The fee schedule was approved by the State Board of Health in August after a lengthy series of workshops and public hearings. It was submitted to he Legislative Commission in October, but put on hold after members objected to some of the significant fee increases.

The state law approved in the wake of the Las Vegas Hepatitis C exposure case requires much more frequent inspections of a wide variety of operations including alcohol and drug rehabilitation programs, adult day care, group homes, ambulatory surgical centers, hospice centers, hospitals, rural clinics and mobile medical units, among others. The Health Care Quality and Complia-nce unit inspects a total of

30 different kinds of health facilities.

The 2009 Legislature approved adding positions to do the inspections and authorized fees to pay for the program.

Willden said because there still is no regulation, there is no money and he already has 11 vacant positions in the Health Care Quality and Compliance section. Without approval of the regulation imposing the fees, he'll have to lay off another 11 workers.

He said that means 22 of the 39 fee-funded positions in that program will be vacant.

"We do not have a revenue stream, a fee stream, to support the inspectors," he said. "If we're running 22 positions short, we can't meet the inspections if we don't come up with a solution."

And he said he needs that solution by January.

Willden said after thousands were exposed to Hepatitis C by unsanitary practices at two ambulatory surgical centers in Las Vegas, lawmakers were right to increase inspections to protect public safety.

Lawmakers ordered annual inspections for ambulatory surgical centers and every 18 months instead of every six years for all other types of facilities.

But the regulation approved by the Health Board increases fees on some operations by several hundred percent. Rural hospitals were among the hardest hit and many of them are on the brink of financial insolvency as it is. Their fees would rise from $750 a year to $4,765.

Other operations including hospices were also hard hit.

Assemblywoman Debbie Smith, D-Sparks, said she has been working on the regulation "every day for a month."

She said questions have been raised about the methodology used to create the new fee schedule and whether it is fair to all the different types of facilities.

Senate Minority Leader Mike McGinness, R-Fallon, said the fees are necessary to support the inspections because "nobody wants to see that program go away."

Smith said the situation must be resolved.

"We do have to take into consideration that we passed a law that requires more frequent inspections and that costs money," Smith said. "One way or another we have to do something about those fees because we have to have the staff to do those inspections."