Legislative money committees begin closing budgets

Legislative money committees began the process of closing budgets Tuesday, starting with the Department of Health and Human Services.

One of the first things they did was adopt Gov. Brian Sandoval’s recommendation to restore the Indigent Accident Fund, which provides money to counties and hospitals for major medical bills that are run up by those who can’t pay.

That funding, about $21 million a year, is generated by a piece of county property tax revenue the counties dedicated to indigent medical care more than 20 years ago. But the cash has been taken from the counties since 2009 to cover the state’s general fund budget shortfall.

According to the budget analysis prepared by legislative fiscal staff, the state has taken $110.4 million meant for the fund over that time.

Officials from rural counties said repeatedly they feared a single major accident in their territories could bankrupt a small county.

“This is the first time since 2008 they’ll get the money,” said HHS Director Mike Willden.

Even better, according to Sen. Ben Kieckhefer, R-Reno, there is legislation in the works that could allow Willden’s office to leverage that money through the Medicaid program to get even more funding for the hospitals that must care for patients whether they can pay or not.

Willden said that with the federal government paying some 64 percent of Medicaid costs, that could turn the $21 million a year into $55 million to $60 million annually for those hospitals.

He told the joint Assembly Ways and Means-Senate Finance subcommittee the added cash could not only increase the amounts paid to cover indigent medical costs but cover other Medicaid-eligible expenses incurred by hospitals, from the tiniest rural facilities to urban centers.

“They’re absolutely going to get $21 million more than they did the last five years,” Willden said. “And they could get up to $60 million if we can leverage federal dollars.”

“It’s a good thing for the counties,” Kieckhefer said. “And it’s a chance to get some of those dollars we keep sending to the feds back into Nevada.”

The subcommittee also recommended restoring funding to the problem-gambling program, also stripped of cash to help balance the budget in the past couple of cycles.

The budgets, as closed Tuesday, put $2 million a year back into the fund to treat problem gambling.

The subcommittee closed nine of the more than 70 budget accounts in HHS Tuesday — the first budgets to be closed this session.

There are just about 400 budget accounts in state government that lawmakers must agree on in order to set the roughly $6 billion general fund, $15 billion plus total state budget for the coming two fiscal years.