County sends UMC oversight change proposal to Legislature
Clark County commissioners on Tuesday approved asking the Legislature for permission to give oversight of University Medical Center to an independent board.
The 4-3 decision came after months of discussions and could chart a new path for the valley's only public hospital, which spends millions on care for indigent patients and hasn't posted a profit in more than a decade.
Placing day-to-day oversight in the hands of a board of local medical experts would make the hospital more nimble and competitive, advocates say. Public hospitals across the country, burdened by rising costs, have been moving toward private models.
But Tuesday's decision was just one in a series of steps to change the hospital's governance. If the Legislature approves the move, county commissioners would still have to vote on a formal agreement. That would be months away, at the earliest.
Commissioner Larry Brown, which voted for the proposal, said asking the Legislature for permission just gives the board another way to turn the hospital around.
"I don't think it's going to save UMC, but I think it's going to give us another option, another tool, to become more (competitive)," Commissioner Larry Brown said.
But not everybody is on board. Statements from the Service Employees International Union Local 1107 foreshadow a fight along the way.
NAYSAYERS
Legislators in February will have the chance to vote on a rough outline of a new UMC. The proposed legislation would remove oversight of the hospital from commissioners and give it to a body of seven to nine local health care experts, whose meetings and contracts would be open to the public.
But the details - such as who sits on the board and how they're chosen - won't be hashed out until after the Legislature approves the rough outline.
No matter what it looks like, commissioners and UMC CEO Brian Brannman said the hospital's unique missions, such as caring for the poor and providing the region's only level one trauma center, wouldn't change.
But some people feel the change is unlikely to solve the hospital's financial problems or fear that it will jeopardize the hospital's employees. The legislation makes several provisions to protect employee rights.
Commissioners Tom Collins, Chris Giunchigliani and Lawrence Weekly were opposed to the idea almost from the start and voted against it.
Collins said he and his peers - not anyone else - were responsible for the hospital. "Giving that responsibility away is not what we're elected and hired to do," he said.
And all three commissioners voiced concerns about what the Legislature will do to the bill. Just because commissioners send the bill to state lawmakers one way doesn't mean it will look the same when it comes back, they said.
"It frightens me," Weekly said. "We don't know what we're going to get."
But their peers on the board were driven by a need for more options to turn around the hospital. The hospital spends hundreds of millions of dollars on indigent care annually and makes enough to cover all but around $70 million of that. Taxpayers foot that bill, and the model is not considered sustainable. And on Monday commissioners heard a report that the Affordable Care Act, known as Obamacare, will cost the hospital an estimated $52 million over the next six years.
The county hired consultants for $450,000 three years ago to come up with solutions. The consultants said changing the governance was one important part of reviving the hospital.
"Governance is not the panacea. It's not going to save UMC," Brown said. "There are so many pieces of the puzzle to make it sustainable. The governance is just one."
A FIGHT AHEAD?
Governance almost certainly won't solve the hospital's financial problems. To do so, Collins and Giunchigliani proposed looking at raising the property tax.
"We have an obligation to fund this hospital," Giunchigliani said.
But Commissioner Steve Sisolak said that they should be exploring every option, including a governance change, to avoid that.
"The only other solution we have is a significant, very significant, tax increase on every citizen in Clark County, and I can't support that," he said.
Several UMC employees and members of the SEIU spoke against the proposal on Monday, fearing that the change could endanger their jobs.
"You all think you're doing the right thing," SEIU President Al Martinez said. "I beg to differ."
After the vote, the local SEIU tweeted that Sisolak made the motion to approve the measure and noted, "Good luck with that Governor's race, Steve," alluding to rumors that the commissioner has higher political aspirations.
They tweeted a few minutes later, "Now on to (the Legislature) with a split 4-3 vote on a bill with tons of opportunities to screw (Clark County)."
Sisolak said that the comments were "exactly" why he voted the way he did. He said political influence shouldn't be a factor in a decision about the hospital.
"It's a sad state of affairs when that's taking priority over what's in the best interests of the residents of Clark County and employees of UMC," he said.
Contact reporter Lawrence Mower at lmower@reviewjournal.com or 702-405-9781.
