By Mark Waite
The State of Nevada community health clinic served 2,403 Nye County patients in a one year period, along with other services like restaurant, school, institutional and jail inspections, a team of state health specialists told county commissioners Tuesday.
The clinic moved to a new location at 1941 E. Calvada Blvd. that it shares with Nye County Health and Human Services as well as the Nye County Veterans Service Office.
But administrators were concerned over possible cutbacks to their programs from consolidation, the fiscal cliff and trying to comply with the new Affordable Care Act.
The community health clinic administered 1,128 child health services, what Community Health region supervisor Maureen Budahl said were things like developmental screening, lead screening, fluoride varnish treatment and immunizations.
They administered 937 adult wellness services including blood pressure checks, cancer screening and other services; had 268 active and latent tuberculosis patients and 187 patients undergoing diagnosis and treatment of sexually transmitted diseases.
Nye County has 349 food establishments permitted by the Nevada Health Division. Environmental health program manager Joe Pollock said a state law passed in the last Legislature, Senate Bill 471, required Nye County to pay $78,673 for the inspection services, in addition the department collects fees that account for about 70 percent of the budget.
Whitney Taylor has replaced Erica Ryan as the primary Nye County restaurant inspector, Ryan is still a secondary inspector. Three inspectors out of Carson City are sent out to help in northern Nye County.
In one year, the state health division conducted 553 inspections, of which 351 were for bars, restaurants and caterers; 98 for markets and delicatessens; 10 in bakeries and warehouses; 89 in school kitchens, eight in jails and institutions, six recreational vehicle park inspections; a bottled water processor in Gabbs and three septic tank permits were issued in Amargosa valley.
“There were 109 food establishments that had at least one critical violation, a critical violation is an imminent health hazard. Of the 109 establishments there were a total of 154 critical violations, in those, 94 of those 154 were corrected on site, 60 were corrected with a compliance schedule which required a return visit by our inspector. The good news is we’ve had no food-borne illness outbreaks in Nye County and we have conducted 100 percent of our statutory mandated inspections for Nye County for the past 12 months and that includes inspecting all your schools and school kitchens twice per year,” Pollock said.
“We want to make sure when we leave that facility they learned something to be successful in that bar, restaurant or whatever they are operating,” he said. “Nobody’s ever happy to see us come in but most of the time they’re happy we stopped by for a visit.”
Mary Wherry, state deputy of clinical services, said they hope to soon begin posting the result of restaurant inspections on their website.
Pollock said the state is talking about regionalization that could reduce allocations for different counties. Carson City, Douglas, Lyon and Storey are talking about creating a quad-county environmental health program that would take away some fees from the state health division, Wherry said, while the state still has to take care of facilities in rural Nevada. Cities like Las Vegas have their own restaurant inspection program.
Wherry said her department has been trying to update the food code to make it current with Food and Drug Administration requirements for food safety. It was a struggle getting it through the state Legislative Counsel Bureau, she said.
Commissioner Joni Eastley said the only complaint she has heard is over mobile food vendors, like barbecue wagons, that are difficult to ensure compliance with law.
“The goal is to protect the safety of the public so we have to hold people to that standard,” Wherry said.
There is a proposal to split apart mental health and development services, merging mental health with public health and development services with aging and disability services, she said.
“The merging of mental health and public health has actually created an awareness in the mental health area around the data we use in public health to look at a population,” Wherry said. “We’re using our epidemiology and our data-driven decision making to look at the mental health system and what the issues are.”
The state health division wants to work with sheriff’s offices and jails on mental health problems, she said.
“We are looking county by county to find ways to partner with the criminal justice system. As many of you know there are a lot of frequent fliers that come in and out of the jail that have a mental illness and if we could partner better to keep them stabilized maybe we won’t have the same event occurring that is costly to everyone,” Wherry said.
The announcement by Gov. Brian Sandoval to expand the Medicaid program to comply with President Obama’s Affordable Care Act means patients using the community health clinics, which serve the uninsured or under insured, will have some insurance either through Medicaid or the new Silver State Health Insurance Exchange, she said.
But Wherry said, “Just because people have insurance doesn’t mean they have access to care. There are significant shortages in the rural areas.”
“Our greatest challenge, and this is what we’ll be sharing with the Legislature, is because we’re not a primary care clinic many of the insurance companies are not recognizing us as providers in the network so we’re not able to bill and be reimbursed for all the services we provide,” Wherry said. “We would suggest there needs to be some kind of insurance reform to get insurance companies to recognize us.”
The state health division is also very concerned about the “fiscal cliff” Wherry said. There is significant federal funding in the community nursing program which could face a 7.6 percent to 8.4 percent cut, she said, they also receive a little funding from the Food and Drug Administration in the environmental health program.
“We have narrowed our services as much as we can so we don’t have to lay anybody off or reduce our services in the clinic. We will be coming back to the counties, if we felt it was to that point,” she said.