Nye County Commission Chairman Joni Eastley accused Nevada Health Centers Inc. of requesting a change in operation to 40 hours per week instead of the Monday-Friday business hours specified in the contract to scale back operations at the Beatty and Amargosa Valley clinics to four days per week.

Commissioners wouldn't move to approve the request.

"It currently says Monday through Friday, eight to five," said Michelle Agnew, Nevada Health Centers Inc. chief operations officer. "It limits us the ability, if we find a provider, from Tuesday to Saturday, let's say."

Eastley said the Nevada Health Centers' board of directors didn't approve Agnew approaching the county commission. She also criticized Nevada Health Centers for not informing county commissioners about their meeting with the Beatty Town Advisory Board this week.

Lilliam Shell, regional operations director for Nevada Health Centers, said the Beatty meeting involved emergency services, not hours of operation. She said Assistant County Manager Pam Webster and Emergency Services Director Brent Jones were invited.

Last July Nevada Health Centers Inc. received an annual contract of $311,000 to operate both health clinics through June 30, 2011, after months of short term extensions.

"This was a competitively bid procurement through Nye County. You were absolutely well aware what the terms of this contract were and what the residents of Amargosa Valley and what the residents of Beatty expected," Eastley told Nevada Health Centers officials. "We entered into a contract in good faith to provide services during those days."

Nye County would have to reopen the bidding process to allow the change in days, she said.

"There should be no surprises here. This is the contract you bid on," Eastley said. "You're reducing the number of days per week you're offering services through this contract."

Eastley said there was a verbal agreement with county officials Nevada Health Centers Inc. would provide a physician four days per week and a female physician's assistant to treat female patients one day per week in both Beatty and Amargosa Valley. The contract added a footnote that the female physician's assistant will be provided to the extent one is available.

Amargosa Valley Town Board Chairman Jan Cameron said there has been a physician at the clinic the last two weeks, but it was a physician's assistant before that.

During a phone interview afterwards, Agnew said it's been difficult to find a provider in the rural areas, since the termination of the J-1 visa program to attract foreign doctors after the Sept. 11, 2001 terrorist attacks.

"Eight years ago there would be 150 applicants for a position in rural areas. Now we're lucky if we get one a year," Agnew said.

Nevada Health Centers Inc. was fortunate to have Dr. Beatriz Ang serving the Beatty clinic for three years until she left in August, 2008, Dr. Charles Quilty worked in Amargosa Valley for eight years until he left for Elko about four months ago.

Agnew said the temporary doctors want to work four day weeks, so they can spend more time with their families in Las Vegas.

"We don't have the pool we used to. We're trying to do the best we can for a community. We just need a little bit of flexibility. That's what we asked for," Agnew said, admitting she was a little taken aback at the meeting.

Dr. Donald Merutka has been stationed in Beatty since August 2008, Dr. F. Matthew Johnson has been stationed in Amargosa Valley for about three weeks, replacing a physician's assistant.

Beatty advisory board member Theresa Sullivan told commissioners, "The town of Beatty has given up a lot over the last several years regarding Nevada Health Centers and the clinic hours. We've gone from having 24/7 coverage to having no call-out coverage, even during lunch time. It really concerns us they want to cut five days down to four. It's really hard to schedule your sickness on a four-day schedule. If we're down to four days, we have three days with no medical care whatsoever."

Agnew replied the last few months her company has been running the Beatty clinic 48 hours per week, Monday through Friday including a female provider, which was the schedule in Amargosa Valley until two weeks ago.

"In the recruitment, limiting yourself to Monday through Friday, our intent is to get a provider five days a week, eight hours a day," Agnew said. "The way the contract is limited today, we may have a doctor who may want Sunday and Monday off for instance."

Eastley asked Nevada Health Centers Inc. why they didn't raise that issue when they were bidding the contract. Agnew said they were temporarily using Locum Tenens, a physician staffing agency, to man the clinics.

Nevada Health Centers Inc. is a federally qualified health center by the U.S. Department of Health and Human Services and is entitled to federal subsidies. The clinics accept patients regardless of their ability to pay.

In the contract the company said every attempt would be made to ensure the availability of a provider during clinic hours. The contract language notes the problems of recruiting medical professionals to rural areas of Nevada and said the clinic officials will make their best efforts to provide alternate staffing when vacancies occur.