Saturday, April 13, 2013

With AB 484 Dead, UMC Plan Reignites Clark County Controversy

Back in January, we looked at the stark divide that was beginning to emerge on the Clark County Commission. On a host of critical issues, there's seemed to be a persistent 4-3 split. Perhaps the one issue this has most often been manifesting itself has been the ongoing struggle over UMC, Southern Nevada's only public hospital.

Earlier this week, the Assembly Health & Human Services Committee heard testimony on AB 484. This bill calls for a new governing board for UMC, but opponents fear it threatens the hospital's mission as a critical health care provider for those who can't access care anywhere else. And opponents fear this bill may actually be a back door route to privatizing UMC.

Yet what truly surprised nearly everyone this week was the appearance of three County Commissioners... To testify against AB 484! No one saw this coming.

“This is a slippery slope. We have a moral obligation to make sure we take care of the needy people in our community,” [County Commissioner Chris] Giunchigliani said. “I would caution that no matter what happens with this bill, which I hope does not pass, that we be very cautious about unintended consequences.” [...]

[Commissioners] Giunchigliani, [Tom] Collins, and [Lawrence] Weekly told legislators that changing UMC’s governance structure wouldn’t address underlying revenue issues that cost the county tens of millions of dollars per year.

Collins called the proposed changes “unproven” and said it was an instance of “government trying to pass the buck.”

Weekly said the proposed legislation wasn’t “genuine” and was being fueled by special interests. He said commissioners should spend more time working on hospital issues before offloading those responsibilities to an independent board.

“If you move forward with this … what you’re going to see down the line is a whole bunch of special interest folks coming out of the woodwork and UMC won’t be that safety net hospital anymore,” Weekly said. “I don’t think enough time has been spent as a board caring for this hospital like we should.”

Giunchigliani said county commissioners need to have the “courage” to take serious action to fix UMC’s financial situation, including possibly creating a countywide tax to help pay for hospital operations.

“We have to clean up our own house to some extent and we don’t need AB484 to do that,” she said. “This bill diverts us from that discussion. We’re not dealing with how do we fund the hospital or add to our payer mix.”

Yes, that actually happened this week. What was supposed to a "Clark County backed bill" drew opposition from three sitting Clark County Commissioners. And yes, the Nevada Legislature took notice.

And as a result, another surprise occurred. AB 484 died in committee yesterday. Remember that yesterday was the deadline for bills to pass from their originating committees. So because the Assembly Health & Human Services Committee took no action yesterday, AB 484 will likely go nowhere this session.

Assembly Speaker Marilyn Kirkpatrick [D-North Las Vegas] said part of the reason the bill failed was legislators were reluctant to get involved in an issue that could be solved at the county level.

“Anytime that any county comes before us and they have a split vote, we try to send things back to them so they can work on them,” she said. “It's really their issue that they need to resolve amongst themselves.”

So it's back to the drawing board for the Clark County Commission on charting the future of UMC. And going forward, UMC will likely remain a county issue for some time. Since AB 484 is no more, the county will probably have to give up any plans to privatize the hospital for now.

Now, it's just a matter of whether the Clark County Commission can overcome this 4-3 divide and come together for a holistic solution for UMC. Again, this is Southern Nevada's only public hospital. And it's the only source for health care for many in Clark County who have the legal right to access health care somewhere in the county.

So what happens next? For now, that big question moves out of Carson City and back to Clark County HQ in Downtown Las Vegas. Good luck with that.

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