Rory Reid testifies against UMC oversight board bill

CARSON CITY -- A legislative proposal to create an appointed board to oversee the operation of University Medical Center would create more bureaucracy and provide less accountability to the public, the opposite of what is needed to get the hospital back on track, Clark County Commission Chairman Rory Reid said Wednesday.

Reid, testifying from Las Vegas against Senate Bill 533, said the elected County Commission, which meets in public, is in the best position to help improve the operation and restore the financial health of the hospital.

An 11-member appointed board of trustees, and the requirement that a professional management firm be hired to run the facility, would not have been able to head off the problems that occurred at the hospital, he said.

The former management team at the hospital misled the commission, and it would have misled an appointed board of directors as well, Reid said.

"To remove elected officials from the front line of responsibility with respect to a public hospital would be a mistake," he said.

The County Commission is looking at different governance structures for the hospital, and will discuss all ideas with the public and stakeholders, Reid said.

The current operating structure for UMC is that the hospital chief executive officer reports to the county manager, who reports to the commission.

The bill was heard but not acted on by the Senate Human Resources and Education Committee, which also introduced the legislation.

Committee Chairman Maurice Washington, R-Sparks, said he sought the bill because of concerns about problems at UMC, including the recent need to pump $60 million into the hospital to keep it solvent.

"This is not an attempt by the state to take over UMC," Washington said.

But if the hospital fails, taxpayers statewide could be on the hook for the costs of such a failure, he said. The Legislature has a responsibility to ensure the hospital continues to operate, given its critical role in providing health care to the state, Washington said.

"If it means we have to hold the commission's feet to the fire to get to that point I think it is incumbent on us as legislators to do that," he said.

Washington said accountability isn't the issue. A 35-member blue ribbon panel was proposed in the bill to provide some expertise on how to improve the operation of the facility, he said.

Reid said the commission will take up the hospital concerns again next Wednesday. The county has hired a consultant to provide information on how other public and nonprofit hospitals are being operated across the country, and what Clark County may be able to do to improve operations at UMC, he said.

"All options are on the table," Reid said.

But creating more layers of bureaucracy as the legislation would do is not the answer, he said.

The bill would create the Blue Ribbon Committee on County Hospitals to review the operation of the hospital. This panel would be appointed by the Clark County Commission, and could include no more than two members of the commission.

This group, in turn, would create from its membership a nominating committee, which would pick 11 Clark County residents to serve as the board of hospital trustees. Board terms would be for two years.

Reid said the problems at UMC came to light through the efforts of the commission, which has held public hearings to deal with the situation.

"In the past few months I think we have made significant progress at the hospital," he said.

Despite such assurances, Sen. Joe Heck, R-Henderson, a physician, questioned whether the commission is in a position to make the best decisions about the future of the hospital.

Heck, who works for a contract firm and who works part time as an emergency room physician at UMC, said the ultimate decision about how the hospital should proceed may best be decided by local health care professionals.

Such a panel might even need to have final binding authority on how to proceed, he said.

"I don't think that this is truly something that the County Commission can make the decision on and have the decision have any credibility," Heck said.

Reid said Heck's proposal may be the right way for the commission to proceed.

"By nature a public hospital has trouble being profitable and rarely is," he said. "That being said, it does not mean that there aren't things that can be done to improve both the governance structure and the operations of the hospital."