Sam Morris / File photo
Wednesday, July 17, 2013 | 7:09 p.m.
Clark County commissioners are taking a step back and turning over most of their oversight authority of the financially challenged University Medical Center to an independent advisory board a little more than a year after a similar setup was shut down due to lack of effectiveness.
Commissioners decided Wednesday during a UMC board meeting to begin the recruitment and selection process for what likely will be a nine-member board charged with overseeing the hospital's operations and long-term planning.
The decision to create an advisory board brings to an end months of at times acrimonious debate on the issue, which initially drew opposition from several commissioners, including UMC board Chairman Lawrence Weekly.
Initial plans discussed included turning the hospital into a nonprofit subsidiary of the county before attention shifted to a legislative bill that would have given commissioners more flexibility when setting up the independent board.
When that bill failed, commissioners regrouped and began discussing what changes are allowed under current state law.
A similar advisory board was established in 2010 and then disbanded 18 months later, but on Wednesday, Weekly said he thinks this time around will be different because commissioners have spent more time discussing what they want to accomplish, leading to a clearer delineation of responsibilities for the new board.
“It wasn’t so much that we didn’t want it; it was just the process and how we got there … for us to talk it out and work it out,” Weekly said. “This time around we took our time. We really got into the weeds of directions and expectations. Last time we just said, ‘Yes, let’s do it,’ and it was more politically driven.”
The split between commissioners was mended in part with the help of Larry Gage, the founder and former president of the National Association of Public Hospitals and Health Systems.
Acting as a consultant, for which he was paid $20,000, Gage spent the past two months interviewing staff and administrators from the county and UMC.
“You’ve brought a lot of our ideas a lot closer together than I thought they would come,” commission Chairman Steve Sisolak, one of the leading proponents for an advisory board, said to Gage on Wednesday.
In his report to the commission, Gage, who created a similar report for the county in 2003, said in his opinion the best model for the hospital is to have an independent board responsible for oversight.
“Even I have been coming here for 10 years talking to you about these issues. Since my last appearance, the importance of dedicated governance for public hospitals has really taken on a tremendous urgency,” Gage said. “Let me be clear: Creating a new governing board is not a panacea. It’s not going to do it all by itself. It is a tool, but I think it’s a very important tool. Hospitals that have taken this step along with many other steps have been more successful by and large than hospitals that have not.”
Having an independent, dedicated governing board “tends to be the standard” among public hospitals and is a model used around the country in places such as Seattle, Atlanta, Minneapolis and Denver, Gage said.
Under the system proposed by Gage, commissioners would retain several duties while continuing to serve as the hospital’s board of trustees, including final approval of budgets, making appointments to the advisory board and signing off on new building projects.
The advisory board would be given oversight of the rest of the operations, with the charge to develop and implement strategies to improve UMC’s competitiveness and efficiency while also looking for new sources of funding to shore up the hospital’s ailing finances, which required a $30 million subsidy from the county this year to make ends meet.
With commissioners’ blessing Wednesday, the staff will begin drafting an ordinance to codify all of the proposed changes into law. At the same time, Gage will be working with county and hospital staff to put together a nominating committee.
That committee, which would be established in September, would be responsible for recruiting candidates for the advisory board, who would then need final approval from commissioners.
Weekly said the goal is to have the new board in place by January.
“What I want to accomplish is to make sure we have qualified individuals who have time to work closely with the CEO to help move this hospital forward,” he said. “As we move forward into the Affordable Care Act, we have to make sure we’re on the cutting edge and that we’re able to compete so we don’t get lost in the shuffle.”