Additional Billing Statistics and Facts

From June 15, 1976, the time the old contract expired, to date there have been 611 screenings performed by OLCHC. Of the 611, 181 were billed at the physician rate of 30 dollars. For the sake of argument, assume that Dr. Ice had screened none of these 181. The clinic's total potential liability is 181 x 10, (the difference between 30 and 20) which is $1,810. Thus the state claim that operation Life Community Health Center over-billed the state for $10,000 is ludicrous. Also the charge that these bills were fraudulently and maliciously submitted, in light of the chronology of events, is ridiculous. There may have been a breach of contract in the sum of $1,810, but in no way fraud. At issue on the other side, were 140 screenings OLCHC performed which were not reimbursed by the state. These 140 have been screened since June 15, 1976. These cases were approved by their individual caseworkers for eligibility but denied for payment by the state. This denial would come only after the screenings were performed. It is therefore a valid contention that the state owes Operation Life 140 (number of screenings) x 20 (the R.N. reimbursement rate) = $2,800. Subtracting OLCHC's potential liability, the state stills owes Operation Life $1,000. This latter statistic further reduces the states claim to $10,000 from OLCHC to ashes. One last note... On November 12, 1976 Ruby Duncan and Dr. James Mcmillan meet with Nevada Governor, Mike O'Callaghan. O'Callaghan stated to the two that there was nothing to worry about, that he (the Governor) would make sure that all sides meet on the matter to resolve differences. However when O'Callaghan reached Welfare officials at NSWD, they refused to meet and said that the matter was closed. "His subordinates refused to sit down and discuss this in an adult fashion" , Mcmillan said on the issue. Although the Judge did not rule in favor of the plaintiffs (OLCHC), there were some good points to come out of the hearings: The Judge felt it necessary to insure that EPSDT was continued by some agency in the black community of west Las Vegas. The state had wanted to re-contract with the Economic Opportunity Board* of west Las Vegas. However, this would have meant moving the EPSDT clinic away from the Operation Life site. Dave Hoggard, executive director of EOB, recommended to his board to enter into a contract with the state for EPSDT services. However a majority of the board was sympathetic to the plight of Operation Life and voted against Hoggard's recommendation The District Health Department was approached by OLCHC people to see if they would be interested in running a satellite clinic at the Operation Life site. They agreed to if such a proposal was brought before the Judge. The court approved the plan whereby the District Health Department would pay Operation Life $ 500 rent and $ 125 maintenance. District Health would perform the screenings without the help of Operation Life workers... The state reluctantly agreed to enter into the EPSDT provider agreement with the Health Department. The Judge was exceedingly fair during the injunction hearings and often pleaded with the lawyers representing the clinic to present their side of the story. Therefore the fairness of the Judge could not be considered as a reason the injunction was denied. If he was presented with the complete story he most definitely would have ruled differently. It was at this point in the trial that Operation Life requested additional money from the Health Department for providing outreach services similar to the way they had under previous agreements with the state. Lawyers for the clinic argued that the Health Departments program was doomed to fail if Operation Life did not provide out-reach. However, Romanelli, states attorney, put on an incredible exhibition, arguing that the state would have nothing to do with Operation Life and they would refuse to contract with the HD if OL people did outreach. She stated that to let OL provide outreach services is to give a green light to all those who want to rip-off the tax-payers of this state. * The Economic Opportunity Board is the designated agency in Las Vegas to administer funds coming into the area that are provided under the Economic Opportunity Act of 1974, as amended, which helps the poor. The Judge refused to rule on the outreach question because he said that he had already over-stepped his bounds by forcing a new EPSDT contract in west Las Vegas, in the interim of the OLCHC/NSWD litigation. He did not feel he had the authority to force specific contractual agreements between the two parties.