Friday, March 25, 2005 | 9:59 a.m.
Members of the Clark County Board of Health expressed outrage and confusion Thursday over a legislative bill they said represents unwarranted interference with their operation.
Assembly Bill 380, introduced on Wednesday, would reduce the size of the board while adding committees to it. Because it refers only to counties with more than 400,000 residents, it would affect only the Clark County Health District.
In scathing comments opposing the bill, board members called it "an insult" and "crap" during Thursday morning's board meeting.
The bill, sponsored by Assemblyman David Parks, D-Las Vegas, would reduce the board's size from 13 members to eight.
Currently, the 13 include elected representatives, medical professionals and members of the public from the county, Las Vegas, North Las Vegas, Henderson, Boulder City and Mesquite. The Health District's functions include enforcing health codes, monitoring diseases, overseeing ambulance transport and preparing for public-health disasters.
Under the new bill, the eight members would all be elected officials. The bill would also create two committees, a health advisory committee composed of medical representatives and a citizens' advisory committee composed of members of the public.
County Chief Health Officer Dr. Donald Kwalick said he didn't understand what was wrong with the board to necessitate changing its structure. "In the seven or eight years I've been here, I don't think there's anything that's happened that we haven't jumped on," he said.
The changes would make the health board both more bureaucratic and less representative of the county's makeup, Kwalick said.
But Parks, who is chairman of the Government Affairs Committee, said the Health District's problems were many and well-known, and said he believed the board was to blame.
He cited as examples the problems with the Health District's former air quality department that led the county to take control of the program in 2001 and the past winter's flu vaccine shortage, for which he said the Health District shared some of the blame.
"They ordered all their flu vaccine from one source, and that one source turned out to be contaminated," Parks said. "And then they had people waiting in the cold in lines around the building to administer the vaccine, rather than setting up various locations around the area."
Parks said he had watched meetings of the board and "there seems to be a lack of engagement on the part of some of the members." He said a committee-driven structure, modeled after the county's flood control and regional transportation districts, would streamline the board and provide a conduit for technical advice.
But board members said there was nothing wrong.
"My dad always told me, 'If it ain't broke, don't fix it, Gary,' " Board Chairman Gary Reese, a Las Vegas councilman, said. "We need to go up there and tell them to leave us alone. We didn't ask for their help."
Board members noted that the state contributes almost no money to the Health District. Of the $55 million the district spent last year, less than 1 percent came from the state general fund, and only 3 percent came from any type of state money.
Gov. Kenny Guinn's proposed budget for the current legislative term eliminated even that small subsidy, known as health aid to counties, and Clark and Washoe counties have been lobbying to get it reinstated.
In a presentation to the board of the district's budget for the coming year, Administrative Services Director Karl Munninger noted that most states contribute about 20 percent of local public-health budgets, according to studies by the National Association of County and City Health Officials.
"The statute says the (state) Division of Health shall provide these services -- it doesn't say the (county) Health District," Munninger said. "The state has in very substantial measure defaulted on those statutorily mandated functions."
Munninger said the Clark County Health District was underfunded compared with both the national average and the Washoe County Health District.
Board member Stephanie Smith, a North Las Vegas councilwoman, said the shortage should not be taken lightly.
"Public health is becoming a No. 1 issue," what with the growing threats of bioterrorism and pandemic diseases, she said. "And yet budget-wise, people don't seem to be taking it very seriously."
The district's lack of resources made the proposal to change the board all the more offensive, members said.
"We've seen how much the state supports the Health District, and yet they want to retain control" over the board's operations, member Susan Crowley said.
The bill would give the county and Las Vegas more representation on the new board than other municipalities, which Smith called "an insult to Henderson" and the other smaller cities.
Reese said the air-quality responsibilities had similarly been taken away from the Health District behind the board's back, "in dark of night." The Assembly bill, he said, "smells of the same crap."
Parks said he supported more funds for the Health District, but the board needed to be more effective and accountable.
"The Health District has come to the Legislature session after session, hat in hand, asking for money, and time after time they've been turned away," Parks said.
In addition to the 3 percent from the state, the district's funding comes 35 percent from county sales, property and gaming taxes; 36 percent from fees; and 26 percent from the federal government, either directly or through grants to the state that are passed on, according to Munninger.
In the coming fiscal year that begins in July, the district's budgeted expenditures are $63 million, a 14 percent increase over the previous year. The board approved the budget at Tuesday's meeting.
The Washoe County Health Board also objects to Parks' proposal. The board voted unanimously Thursday afternoon to oppose it, District Health Officer Barbara Lee Hunt said.
Washoe could be affected by the bill's proposed changes if it grows slightly larger -- current estimates put the population at about 383,000.
"The main feeling among the board was that our current system is not broken," Hunt said.
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