Health District raises salaries for employees, fees for public

By Joe Schoenmann

Wednesday, June 30, 2010 | 2 a.m.

UPDATED STORY: Health District board members: Reconsider fee increases

Having already agreed to 5.5 percent raises for most of the Southern Nevada Health District's 526 employees, the board that oversees the agency last week approved a raise for its chief health officer and at the same meeting voted to increase some of the fees it charges the public for vaccinations and other services.

“They’re raising fees on senior citizens to get a pneumonia vaccine, which doesn’t make any sense to me when they apparently have enough money to give out these big raises,” Clark County Commissioner Steve Sisolak complained after he heard about it.

The Health District board on June 24 approved a new base salary of $255,096 for Dr. Lawrence Sands. His base salary in his last contract, approved three years ago, was $225,000. The Sun began asking questions about the new contract Friday morning, and that night Sands e-mailed a letter to his board members saying that “in good conscience” he could not accept the cost of living raise they were offering him.

“The financial stress our community and residents are enduring weighs heavily on me both personally and professionally as a public health physician,” he wrote.

At the county government building, for example, more than 1,000 positions are not being filled, more than 200 full-timers and countless part-timers have been laid off, and commissioners and the county manager have been fighting unions for salary and benefits concessions.

His prior contract had a provision that the board could give Sands the same percentage cost of living raise as given to other Health District employees, and he had received those raises in each of the last two years, which had raised his base salary to $247,665 as of last month. It was the most recent cost of living raise, $7,420, that Sands gave back.

The 5.5 percent raises at the Health District stem from a union contract approved in 2008 that gives Service Employees International Union employees a 3 percent cost-of-living raise and 2.5 percent step raises. Union employees for Clark County also had built-in cost-of-living raises, but last year the SEIU agreed to cut those increases to ease the county’s fiscal crisis.

Linda Strickland, a Boulder City councilwoman who served as chairwoman at the Health District’s board meeting last week, said as far as she knew the board never asked the SEIU for voluntary salary concessions.

If it had, the union was prepared to argue that the Health District had enough money to fulfill the terms of the 2008 contract, said Amber Lopez Lasater, spokeswoman for the union local.

As of June 2009, it had a balance of about $25 million, more than one-third of its 2009-10 expenses of about $68 million.

Lopez Lasater pointed out that Clark County’s Taxpayer Bill of Rights recommends the county keep reserves of only 8 to 10 percent of its general fund expenditures. That guideline, however, does not apply to other agencies, such as the Health District.

Clark County’s reserve for fiscal 2010 was $124 million, or 9.5 percent of total expenditures of $1.3 billion. But most of that fund balance will be wiped out in the fiscal year that begins July 1 because the county is using most of it to help balance its overall budget.

Strickland said the Health District’s healthy bottom line is the result of cost efficiencies and streamlining. “As an example, we’ve gone paperless,” she said. The agency also has refrained from filling 50 openings.

As for the relatively large balance, she said that money is necessary because “it helps ensure (that) when outbreaks occur, (the district has) the funds to deal with it.” The Health District’s audit committee has recommended the agency keep a reserve amount equal to about two to three months of general fund expenditures.

To protect that large balance — which will fall to $18 million in the coming fiscal year — the district’s board had even discussed creating a fund to “hide” the money, said Commissioner Lawrence Weekly, one of the Health District board members.

The agency’s fear was well-founded. In 2009, county officials said the state made moves that effectively deprived Clark County of $180 million over two years.

But Weekly said he successfully argued against the Health District hiding its reserves. “When it gets to the point where you hide money, it takes away the transparency and trust,” he said.

Sisolak said the amount of reserves makes him wonder whether taxpayers’ elected representatives have put too much trust in the district. In other words, he’s wondering whether the county is giving the district too much money. “I think we have to look at whether or not they need all of that money,” he said.

In fiscal 2010, the Health District got 36 percent of its funding from the county, 2 percent from the state, 13 percent from the federal government and 49 percent from the regulatory and service fees it charges.

In the coming fiscal year, the Health District expects to spend about $82 million, an increase of 6.6 percent.

The Health District is overseen by a 13-person board whose membership, as dictated by state statute, includes appointees from the county commission, the various city councils from throughout the county, representatives of the medical community, an environmental health representative and a representative of a business that could be affected by the board’s decisions.

Neither of the two commissioners who are on the board, Chris Giunchigliani and Weekly, was there for the vote on the Sands contract and to finalize the budget that included the raises for other Health District employees. Giunchigliani was on vacation last week and Weekly had left before the vote.

The only board members to vote against the raise for Sands were Henderson City Councilwoman Kathleen Boutin and Las Vegas City Councilman Steve Ross.

Boutin, a one-time SEIU member, said she is going to ask for a reconsideration of the fee increases “because I’m not so sure that raising fees so we can pay employees is the direction the Health District needs to go.”

Ross said the board’s approval of Sands’ raise “set a bad precedent, when we’ve got local government struggling and laying off employees across the spectrum.”

“They aren’t in debt and Dr. Sands does a great job, but what kind of message does that send, especially when we’re laying people off?” he said.

Strickland, however, said the new contract awarded to Sands was not a raise, because it only followed the increases given to the Health District’s union employees.

“He was entitled by contract to receive a (cost-of-living adjustment) any time the other employees did,” she said.

But, she added, at last week’s meeting the board also disconnected future “adjustments” of the chief health officer’s salary from union employee “adjustments.”

No matter what any other elected officials want to call the raises, they have Sisolak on the verge of calling for an overhaul of the way the Health District operates and its relationship to the county government.

“I think we have to look at the whole system of what’s going on here,” he said. “How can you lay off people in one department and give raises in another? This is crazy. It feels fundamentally broken.”