UMC ‘crisis’ remains thorn for commission

Wednesday, Jan. 22, 2003 | 11:35 a.m.

A day after Gov. Kenny Guinn painted a bleak financial picture of Nevada's coming year, Clark County commissioners sketched a similar portrait in their annual State of the County report Tuesday.

The centerpiece of the county's fiscal woes is the University Medical Center, which had a 28 percent increase in patients without health insurance coverage last year, representing a $7.1 million increase in unreimbursed costs. The hospital, which required a $38 million infusion of county cash in December, is still hemorrhaging about $2 million a month.

Minutes after the county commissioners presented their report, they appointed a 10-member panel to evaluate the hospital's operations and to define its long-term role in the community. Meanwhile the commission and county staff are also looking at hospital operations, seeking ways to control costs while maintaining or improving the institution's quality of care.

County Manager Thom Reilly warned that if changes are not made, the impact on the region's largest health-care provider could be severe, leading to restrictions on the kinds of care that could be provided, including restrictions on surgical procedures.

"We clearly have a crisis" at UMC, Reilly said after the report.

Commissioner Yvonne Atkinson Gates said the "serious finanical crisis for both the hospital and the county" was created, in part, by a "skyrocketing" number of uninsured patients requiring treatment at UMC.

"Through just the first five months of this fiscal year, the hospital has incurred more than $15 million in losses and threatens to disrupt the county's ability to sustain all of the other programs we are legally mandated to provide," Atkinson Gates said.

Commissioner Rory Reid, elected in November and sworn in as a new board member this month, said "the board will have to make some difficult policy decisions in the coming year and we may have to consider measures that may not be widely embraced. But one thing is clear: We simply cannot continue to subsidize UMC at the same level we did this year."

The county's woes do not end with the hospital, however. The strain on the county is driven by the population boom that is requiring an ever-greater commitment of resources.

"We have serious concerns about our ability to provide adequate fire and emergency service staffing for new facilities needed to keep up with growth over the coming years," Commission Chairwoman Mary Kincaid-Chauncey said.

A two-year economic downturn shaved millions from county tax revenues, and services are stretched thin, commissioners said. They directed many of their comments at the Legislature. Local governments fear that the state will attempt to redirect local tax dollars to state programs.

Kincaid-Chauncey said 45 percent of local tax revenue goes to public safety needs, particularly the growing needs of police and fire services.

"We have a number of extremely important public safety-related resource demands that confront us, and I am extremely concerned about our ability to address these needs in the difficult economic times that we live in," she said. "Any changes in our revenue base can and will affect our ability to provide additional resources in the important public safety areas I've mentioned."

Reilly, Kincaid-Chauncey and Commissioner Myrna Williams repeated a virtual mantra of local government officials: Keep the state's hands off local revenues. Williams added a second provision: Don't shift more responsibilities to the county government during this period of fiscal uncertainty.

Williams said either possibility would mean the loss of important services for local governments.

"We're going to do everything we can to ensure that doesn't happen, but a lot depends on the Legislature."

She said problems in the tax structure and distribution system are nothing new.

"I think people as far back as 1987 or '89 realized that our tax system was going to implode on us," Williams said, adding that she believes it is in that state of implosion now.

But a dramatic overhaul of the system is not what local officials want to see now.

Reilly pointed out that the governor's Monday night address did not call for a redistribution of tax money from local governments to the state. Guinn proposed nearly $1 billion in new taxes to support state programs, including transportation projects and other efforts that would benefit Southern Nevada.

Reilly said he has received personal assurances from Guinn, his staff and some members of the Legislature that they will oppose any attempt to redirect revenue from local coffers to the state.

But even without the tax shifts, times will likely be tough. Reilly said a hiring freeze instituted last year will continue.

Williams said the crunch will mean county employees will have to work harder to cover the difference.

The sluggish national economy has affected the number of tourists coming to the area. Visitor volume is down about 2 percent from two years ago, Gates said.

"This lack of growth in visitor volume and the resulting impact it has on our economy is clearly affecting our ability to maintain county service levels in the face of continued population growth," she said. "Given current economic conditions, it is not likely that we will see any significant improvements in the resources we have at our disposal for the foreseeable future."

Not all the talk Tuesday was on the county's fiscal situation. Commissioner Chip Maxfield, speaking via a prepared videotape, reviewed a new proposal to reform the county's land-use planning process. The process has been criticized by residents who say re-zoning has been detrimental to their quality of life.

"Over the past year, there have been numerous, sometimes controversial land-use changes proposed, particularly in the county's growth frontier areas of Spring Valley and Enterprise," Maxfield said.

Maxfield and several of his colleagues have called for stronger, more reliable master plans to guide development. They are scheduled to introduce an ordinance at today's zoning meeting that would bar amendments to land-use plans for two years after their adoption, and would require a two-thirds "super-majority" to approve zone changes that do not conform to those plans.

The introduction "will mark the starting point for dialogue on this important issue," Maxfield said.

County spokesman Eric Pappa said Maxfield missed Tuesday's meeting because he was on a personal trip. Commissioner Mark James also missed the meeting.

Kincaid-Chauncey said James is in Reno caring for his critically ill mother.

While most of the State of the County report was on the challenges ahead, the commissioners took time to recognize accomplishments of the last year, including improvements in transportation and air quality.

The U.S. Environmental Protection Agency has given tentative approval to county plans to control fine dust and carbon monoxide pollution, Commissioner Bruce Woodbury said.

"Air quality is improving," said Woodbury, who has the longest tenure of any commissioner on the board.

Woodbury, who also serves on the board of the Regional Transportation Commission, said road improvements have provided relief to traffic congestion. Work on Interstate 215, the Las Vegas Beltway, continues, with six miles left to be completed on the 53-mile road looping around the southern, western and northern parts of the valley.

Work on roads designed to relieve congestion along the Strip continues, and a parallel effort to extend the Las Vegas monorail the length of the commercial corridor should be completed early next year, Woodbury said.

Despite the tax battles already brewing in Carson City, Woodbury said he is confident that the Legislature will approve $2.7 billion for Clark County transportation projects over the next 25 years, a total mostly funded through additional sales taxes. The tax package was endorsed by Clark County voters in November.

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