Clark County commissioners acted tense as they voted Tuesday to reduce staffing in the coming months and revamp the beleaguered University Medical Center.
Most of them stared down at the dais. A couple fidgeted nervously.
Twenty-three county managers will lose their jobs, either by pink slip or demotion, in three weeks. No other estimates of potential layoffs were given.
Yet within buzzwords such as "consolidation," "streamlining" and "restructuring" was the promise of county workers being laid off sometime this year.
For months, county leaders have said the mounting red ink would force layoffs. Tax revenue is skidding for the second year in a row and is expected to cause a $126 million shortfall in the next budget year.
Commissioners acknowledged in a roundabout way that they soon would decide which county workers would still have jobs at the end of 2010.
"In a time like this, we need to be more efficient," Commissioner Rory Reid said.
In a 5-2 vote, commissioners approved a multifaceted motion that somewhat echoed a plan Reid had unveiled Monday to fix the county's financial ills. Commissioners Chris Giunchigliani and Lawrence Weekly voted against the motion.
Giunchigliani opposed changing UMC from a public hospital. Weekly was displeased about the board not being more involved in deciding which county managerial jobs would be cut.
The motion called for:
• Slashing the 23 management jobs. Some of the employees will be laid off and others can choose between being demoted or fired.
• Eliminating redundant jobs in administration, human resources, finance and maintenance. For instance, rather than having a finance person in every department, these tasks can be handled through a central office. Maintenance at the parks, jail and other facilities also can be centralized.
• Changing UMC to a different business model, such as a nonprofit or full-fledged teaching hospital. No one mentioned privatizing it.
• Having county managers negotiate with unions to reduce labor costs.
• Consider recommendations from the 15-person advisory panel about handling the county's budget problems. The panel is scheduled to discuss final recommendations Thursday and draft a report in two weeks.
A few commissioners, including Reid, expressed hesitance to follow the panel's advice. Some panel members called county workers' wages and benefits unsustainable and lambasted firefighters' salaries as "outrageous."
Commissioner Tom Collins defended firefighters, saying people don't complain about how much a firefighter earns when it's their lives being saved. During medical calls, firefighters are often exposed to contagious diseases, he said.
"They should be applauded and not criticized in the media," Collins said.
Collins argued that the county should hire more firefighters to reduce overtime costs. He said two new stations opened recently but no new firefighter jobs were created.
Commissioner Steve Sisolak countered that it wasn't fair for firefighters to pull in such high wages while other workers take reduced pay raises and face layoffs.
"We cannot afford to have one group making $200,000 a year on average," Sisolak said.
Reid said the task force might offer useful advice, but the commission isn't obliged to accept it. Commissioners should study the report carefully before adopting anything, he said.
Most commissioners agreed that UMC can no longer operate as a purely public hospital that treats all patients, including those who can't pay. Last year, the hospital lost $82 million and needed $140 million in subsidies.
"UMC has a disproportionate burden to provide charity care," Reid said, adding that the area's for-profit hospitals must take some of that burden.
Both Reid and Sisolak said the county doesn't need to throw together any more study groups or committees to analyze UMC's woes. Something drastic needs to be done, they said.
Giunchigliani opposed changing UMC to a for-profit or nonprofit hospital.
"We're a county hospital and should serve the public," Giunchigliani said. "I don't think UMC is entirely broken."
The county and its unions will begin meeting by Feb. 1. The firefighters' labor contract is up for renewal this year, and the county employees' union agreed to resume talks about trimming labor costs.
"They (workers) have done their part, and they continue to do their part," said Amber Lopez Lasater, spokeswoman for the Service Employees International Union Local 1107.
Last year, the union, which represents about 9,500 workers, agreed to have cost-of-living raises shaved to 1 percent from 3 percent. In return, the contract was extended to mid-2011, on the condition that bargaining would resume this year if the economy didn't improve.
Commissioner Larry Brown called it "the most important bargaining session in Clark County's history."
The county has enjoyed double-digit growth for 30 years, allowing generous labor contracts to be forged and ample services to be created, Brown said. But tougher times call for austere measures.
"We have a chance to change the way we look at how we provide services," Brown said.
Contact reporter Scott Wyland at swyland@ reviewjournal.com or 702-455-4519.