Published Wednesday, Nov. 14, 2012 | 10:04 a.m.
Updated Wednesday, Nov. 14, 2012 | 12:22 p.m.
A vote on a proposal that Clark County cede direct control of University Medical Center to a semi-autonomous board has been delayed, but not before raising the hackles of hospital union workers — and several county commissioners.
Commissioners, after a lengthy discussion at their Wednesday meeting, decided to put off a vote until Dec. 5 on a measure that would send a proposal for changing oversight at the county-owned hospital to the 2013 Legislature. Among other things, the proposal would allow the newly formed board to have its strategic meetings behind closed doors.
Union members who work at University Medical Center told commissioners the secrecy of the would-be hospital board is wrong. They also worried aloud the move was a step toward privatizing the hospital.
Two people who said they represented the Latino community said they were “very against” changing the hospital structure. Having the meetings closed "would not let our constituents know what is going on."
Another speaker urged the county to look to the Legislature to change the funding formula that allows redistribution of UMC-generated funds, via Clark County, to other parts of the state. If that formula was changed, UMC would be on sounder financial footing, he said.
The union's worry, county administrators say, is the proposal might end up weakening the union's stance with the hospital. The hospital's stance, the administrators said, is solidifying UMC's future in the highly competitive healthcare industry.
For years, hospital administrators have said representatives from private hospitals come to the UMC meetings, which are now open to the public, learn about the direction the hospital wants to go, then quickly move their own programs in that direction. The result sometimes means UMC, southern Nevada's only taxpayer-funded hospital, loses potential business.
University Medical Center operates at an annual loss of about $75 million, despite Clark County subsidizing it to the tune of about $150 million annually.
A UMC administrator says the bill draft would allow the county to create a subsidiary that would have "some" attributes of a private hospital but would mostly preserve the public character of the hospital.
"We need the legislation to achieve the goals ... " that commissioners have previously stated.
Addressing union members, she said, "This is not a private entity."
The proposal before the commission was only enabling legislation, she added, and if approved by the Legislature would require approval by county commissioners to actually change the hospital's governance structure.
Hospital administrators said the changes were necessary to ensure the life of the hospital for another 100 years.
Commissioner Tom Collins, signaling his disenchantment with the proposal, characterized the effort to change the hospital as "passing the buck."
"UMC is the people's business to take care of," Collins said.
When he said UMC "saved' his life two decades ago, union members erupted in applause.
"There's got to be a way to fund this hospital (without) turning it over to someone else," Collins said.
Commissioner Mary Beth Scow said she had some problem with the proposal, which she said had "some weaknesses."
"The commission should approve bylaw changes ... but my greatest concern lies with the board and its formation. We need to be more specific in categories of the board, it needs to be a professional board, a paid board, perhaps," Scow said.
Commissioner Chris Giunchigliani sounded like she didn't want any changes to University Medical Center, hence there'd be no need to ask the Legislature to amend state law.
"I'm still trying to ponder what we are trying to fix and how we got here," she began.
"I think we're trying to fix something that really isn't the problem. The problem is the financing, taking money from the county coffers. It's a regional hospital, but not everyone is sharing the cost."
But when have the other communities served by the hospital, such as Las Vegas, North Las Vegas and Henderson, been asked to talk about helping out?
Giunchigliani said the bill draft was an "excuse to not look at a taxing district (to help fund the hospital), which we already have the authority to do. There's so many things we have the chance to do to raise additional revenue and we haven't done it."
"This could be the death knell for UMC," she added.
Commissioner Lawrence Weekly, noting patients from all over the valley use UMC, joined Giunchigliani and wants to begin the process of inviting other local municipalities to talk about sharing the hospital's cost.
Commissioner Steve Sisolak added that, perhaps, a change in the state's formula for distributing consolidated tax revenues might help UMC. Sisolak has previously voiced support for forming a "hospital district" to help fund the struggling hospital.
Al Martinez, head of the Service Employees International Union, told hospital administrators, "I'm going to fight you."
"We're going too fast; I feel it," he said, adding this warning: "You better be careful what you ask for."
Having dissected the proposal, commissioners agreed to discuss a more detailed version of the bill draft at their Dec. 5 meeting.