Monday, April 14, 2014 | 2 a.m.
The Clark County Commission will consider a $25 million emergency loan for the University Medical Center during its meeting at 9 a.m. Tuesday. Hospital executives say that without the loan, they won’t be able to pay employees or vendors.
Commissioners also will discuss new rules for tavern gaming and the conduct of Commissioner Tom Collins.
The meeting will be at the Clark County Government Center, 500 S. Grand Central Parkway.
Hospital seeks quick financial fix
UMC has struggled with operating losses for years because it specializes in serving low-income people who don’t have insurance.
But the hospital’s typical budget woes have been exacerbated this year since the Affordable Care Act took effect and Medicaid coverage expanded in Nevada. The hospital has seen a sharp increase in Medicaid patients since the expansion, but the state hasn’t reimbursed UMC since the start of the year.
Although state officials promised to make the payments, they might not come soon enough for the hospital to make payroll and vendor payments that are coming due.
UMC is seeking its second emergency loan from the county this year. The commission approved a $20 million loan in January and will consider an additional $25 million Tuesday.
Under the deal, the hospital is supposed to pay back the loans. At the same time, UMC is asking the county to boost its ongoing annual subsidy from $41 million to $71 million.
Tavern gaming under the microscope
The long-simmering battle between neighborhood slot parlors and casinos reignited last month when commissioners said they consider changes to tavern gaming rules.
The fight for the local gaming market has pit neighborhood stalwart Dotty’s against larger casinos, such as Station Casinos, which runs nine large casinos.
On Tuesday, county staff will share public comments they collected during an April 4 workshop. The commission will discuss possible rule changes but is not expected to vote Tuesday.
The debate centers on how the county’s rules define the word “incidental.”
Taverns with restricted gaming licenses, such as Dotty’s, are allowed to have up to 15 slot machines as long as gaming revenue is “incidental” to the primary business of selling food and alcohol.
But the county never defined “incidental” when it approved new tavern gaming regulations in 2011. Critics say Dotty’s has exploited that loophole to fuel its growth across the valley. As of last summer, Dotty’s had 65 Clark County locations.
Slot parlors such as Dotty’s are licensed as taverns but offer limited food and drink options. A previous audit showed some Dotty’s locations get far more than half of their revenue from gaming.
Some commissioners say slot parlors' gaming receipts should be closer to half of the business revenue. They hope to define “incidental,” but doing so could generate fierce opposition.
Collins’ statement draws scrutiny
Commissioner Tom Collins’ profanity-laced statement last week to supporters of embattled rancher Cliven Bundy have landed him in hot water.
During a phone call with a county commissioner from Utah, Collins warned that any Utahns coming with guns to help Bundy “better have funeral plans.” Collins also referred to Utahns as inbred and used several expletives, according to a Facebook post made by Darin Bushman, the commissioner from Piute County.
Collins has tried to clarify the remarks, saying that he was only trying to discourage violence by telling armed Bundy supporters to stay away.
But his efforts haven’t been enough to quell the controversy.
Although Collins’ behavior is not listed on the agenda, Commission Chair Steve Sisolak plans to lead a discussion about the decorum of board members. It's not clear whether Collins will face any sort of formal reprimand.