LAS VEGAS (KTNV) — This Pride Month, one of Southern Nevada's most prominent healthcare providers for the LGBTQ+ community is temporarily closed, leaving thousands of patients searching for care as the owner pushes for legislative and social change.
THE MISSION
Rob Phoenix opened the Huntridge Family Clinic back in 2013 with the goal of turning barriers to care into bridges, particularly for marginalized folks.
"I wanted to have a clinic where people could just access care because they needed it. If you were positive that was awesome, we'd take care of you. If you were diabetic, if you were gay, straight, bi. It didn't matter if you had insurance, if you wanted to pay in tamales, chicken eggs, whatever, we'd figure out a way to do that. That's kind of how we started the clinic and kind of how we've always operated," Phoenix said.
JP Coleman is one of the many patients who turned to Huntridge when they really needed it.
"When I found this place, I really, really respected it after my first visit because I wasn't judged. I was completely honest with my provider. At the time, I was using methamphetamines and stuff like that and they didn't judge me," Coleman said.
Through compassionate care, Coleman found his purpose. He later became a medical assistant at Huntridge, doing a variety of jobs there, including HIV case manager, lab technician, and peer support navigator.
THE CLOSURE
"I've always had a problem telling people no. That's not a word that's big in my vocabulary. It's a very lowercase word when it comes to access to healthcare," Phoenix said.
Because of this approach to healthcare, Phoenix said his business has always lived on the edge, in terms of finances.
"My philosophy has always been care-first. I've never worried about the bills. I've struggled with paying rent and things for 10 years but I've always been able to make it," Phoenix said.
But this time, he couldn't make it. In April, he notified his staff they were being laid off and the clinic would close its doors.
"It sucked because we were planning on doing so many things for the community and then, all of a sudden, everything got cut, wiped out from under us. It was a shock," Coleman said.
Phoenix cites several reasons for the closure including delayed grant funding and the struggles of serving the LGBTQ+ community in this political climate. He adds that as a family nurse practitioner, he doesn't get the same insurance reimbursements as physicians and that has always been a financial strain on his practice. Furthermore, he also attributed the closure to the difficulty of being an independent healthcare provider in a healthcare marketplace that's seeing increasing consolidation and monopolization.
"All of these things just kind of snowballed and hit us all at the same time and it just sucks," Phoenix said. "It's the hardest thing that I've had to do in my professional career ever."
THE TRUST GAP IN A MEDICAL DESERT
Since the closure, Phoenix said they have still been working to refill prescriptions for patients when possible and sometimes, have some patients living with HIV come in to do group infusion treatments. Phoenix has been working to refer his patients to other providers but he added that's easier said than done.
Finding another clinic is no easy task for the thousands of patients -- 85% to 90% LGBTQ+-identifying -- who have been impacted by Huntridge's closure, Phoenix said. According to the Nevada Health Workforce Research Center, about 1.5 million Clark County residents live in areas facing a primary care health professional shortage.
For many folks, it's not just a matter of finding a healthcare provider. It's more so about finding a trusted one.
"We are a family. The LGBT community is a family and it's really hard to find a safe place where you are respected, understood, and heard," Coleman said.
A global poll conducted by Sanofi surveyed more than 11,500 people in five countries about their healthcare experiences with large sample sizes coming from marginalized groups. It found that 66% of people who identify as part of the LGBTQ+ community are more likely to say that they have had experiences that damaged their trust in healthcare than their straight counterparts.
"Lots of patients report that when a provider finds out they're gay or lesbian or trans, that changes the tone of the visit and it's an unfortunate reality, still, in today's society, that many patients are stigmatized, are told 'we don't do that kind of care here,'" Phoenix said. "There's pages of data of how much disparity the LGBT community experiences -- access to care, not having insurance, not being able to access to care, being misgendered, being misnamed, being treated with disrespect."
PUSHING FOR PARITY
Phoenix believes legislative change is a big key to helping sustain businesses like his and improving access to care. Several bills were presented during the most recent legislative session in Nevada that could help address some of the issues he sees in the way the healthcare industry currently operates.
He said one of the biggest issues putting a financial strain on his business was provider parity -- or the lack thereof. He said as a family nurse practitioner, he doesn't get reimbursed by insurance companies at the same rate as his physician counterparts.
"My reimbursement was 80% of my physician colleagues. My expenses are not 20 percent less," Phoenix said.
That's why he pushed for Senate Bill 201, which would improve parity for pharmacists when they perform certain other healthcare services. However, according to the state legislature's website, the bill stalled in a committee this legislative session.
Phoenix also applauded the signing of Senate Bill 119 into law, making the pandemic-era expansion of telehealth services permanent by requiring third-party insurers to cover telehealth at the same rates as in-person care. He said that will help increase access to care as well as support providers.
Additionally, Phoenix is also advocating for Senate Bill 439, which was passed by both chambers of the legislature. As of June 12, it was on the governor's desk awaiting his signature. The bill would help increase access to HIV prevention services and reduce the stigmatization of living with the virus. It's a topic particularly dear to Phoenix, who said the Huntridge Family Clinic was the largest provider of PrEP in southern Nevada, which can reduce your chance of getting HIV from sex or injection drug use.
Phoenix said he had high hopes for Senate Bill 302 too, which would protect healthcare providers from repercussions for providing gender-affirming healthcare services to someone from another state where those services might be restricted or outlawed. That bill was passed by both chambers but was vetoed by Governor Joe Lombardo. It has not been overridden.
However, Gov. Lombardo did sign another bill into law that has similar sentiments. Senate Bill 131 protects out-of-state visitors from abortion prosecution as well as the healthcare professionals who provide those services.
Phoenix added that education is another way to improve the LGBTQ+ community's trust in the healthcare system. Before the clinic's closure, he hired several young nurse practitioners because he said he wanted employees who would approach the job without preconceived notions about healthcare. He wanted to teach them how to interact with patients according to his philosophy of care.
"One of the challenges is education. A lot of providers don't get education around competency in the gender diverse community," Phoenix said. He believes a more compassionate healthcare industry will make for a more hospital environment for clinics like his.
MAKING A COMEBACK
Despite all of these challenges, Phoenix believes his beloved Huntridge Family Clinic will once again be a fixture of southern Nevada's LGBTQ+ community.
"I've been advocating for my community for 10 years and I'm not stopping. We're not stopping. We're not done. We're not gone," Phoenix said.
He said he's currently in discussions with a company that will help them become more financially stable. He hopes to reopen in early July.
While they will remain closed during the month of June, which is widely recognized as Pride Month, Phoenix and Coleman hope they'll be welcoming patients again when Las Vegas Pride celebrations roll around this fall.
"I really hope that during October when we have Pride here in Las Vegas -- because you know it's too hot to have it here in June -- I hope we're back bigger, badder, stronger, doing more than we ever thought we could," Coleman said.
