Sometimes minority controls the power

The infighting among Clark County commissioners erupted again Tuesday over the county hospital, which is predicted to have an $87 million loss in 2014, a $20 million drop from 2012 and yet another sign the hospital is hemorrhaging.

Their public display of disaffection dominated the discussion about University Medical Center.

To understand Tuesday’s outbursts, go back to January, when commissioners split 4-3 over the proposal from the hospital’s CEO Brian Brannman to create a nonprofit governing board to focus entirely on the county hospital.

That would shift power away from the commissioners and let a board of experts focus on the hospital alone, instead of spreading the commissioners’ expertise among the hospital, airport, water district, health district and other regional responsibilities. The proposal for a change in governance was based on one in Minneapolis, the Henneprin County Medical Center and has been recommended for UMC by consultants.

Four county commissioners liked the idea, three did not. After the vote, Commissioner Tom Collins tweeted, “PTA moms over their head.” It was a contemptuous snipe at Commissioners Susan Brager and Mary Beth Scow, former School Board members, who with Commissioners Steve Sisolak and Larry Brown, aligned as the majority.

Assembly Bill 484 was introduced in March. Note, this bill didn’t create a new entity to oversee the hospital; all it did was enable the county to explore the idea.

But the minority trumped the majority. Commissioners Collins, Lawrence Weekly and Chris Giunchigliani killed the bill by testifying against it in front of the Assembly Health and Human Services Committee on April 10.

The threesome, backed by the Service Employees International Union, convinced the chairwoman, Assemblywoman Marilyn Dondero Loop not to bring the enabling bill up for a vote. So it’s dead. The power, as well as the responsibility, remains with the county commissioners.

None of the four commissioners who supported the bill showed up. Instead, they sent UMC’s Brannman to pitch it. He was backed by the Las Vegas Metro Chamber of Commerce and the Nevada Resort Association, but they didn’t send the same political message as the SEIU, which has 18,000 members statewide and carries political clout in elections. Nor did they carry the emotional wallop of UMC employees frightened about losing benefits under any reorganization.

The death of AB484 drew scant media attention. The ones who rejoiced were the union folks, Weekly, Giunchigliani and Collins. Weekly is the chairman of the hospital board, and Giunchigliani is the vice chairman. Both thought their views should guide the other commissioners.

During the legislative testimony, Collins again took swipes at Brager and Scow, describing them as former School Board members who oversaw the financially troubled school district, but not very well.

A clearly angry Brager, referring to Collins’ legislative comments, said Tuesday, “I don’t disparage anyone on this board, and I don’t think anyone should be disparaged.”

Weekly angered the majority of four by telling legislators some of his colleagues didn’t care about UMC or poor people.

“I know in your heart you didn’t mean that,” Brown told Weekly at the commission meeting. Then he chided commissioners who “sometimes get way too involved in the minutiae of day-to-day operations. That’s not our job.”

The next phase of this epic discussion will be about how to pay for UMC, which doesn’t draw enough paying customers to cover the deficit and carries the burden of caring for the uninsured.

Put simply: Do you raise revenues or cut expenses?

Since Sisolak already said he will not support a countywide tax as Giunchigliani wants. I can easily foresee another 4-3 vote killing a tax hike.

In 10 years, UMC’s annual operating loss has gone from $14 million to a projected $87 million.

That’s not exactly a sign of progress under the governance of county commissioners.

Jane Ann Morrison’s column appears Monday, Thursday and Saturday. Email her at Jane@reviewjournal.com or call her at (702) 383-0275.