Problems at the Southern Nevada Health District run deep

Chief Health Officer resigns amid controversy

LAS VEGAS — So ... just how deep are the problems at the Southern Nevada Health District?

And will the public ever learn the full story?

Today, the district Board of Health is scheduled to accept the resignation of Chief Health Officer Dr. Lawrence Sands, which was announced Friday.

Sands has worked for SNHD since 2004 and since 2007 has been the nominal leader of the organization.

But on May 15, a firestorm of raw hostility, blasting forth from Clark County commissioners, had made it clear that the Sands era was over.

On the commission’s agenda, at the time, had been consideration of the health district’s proposed fiscal year 2013 budget.

County staff set the scene by reminding commissioners that SNHD had finished FY 2011 with a remarkably large ending-fund balance of 54.5 percent — at a time the county itself had been scrimping and seeking give-backs from the powerful unions that had helped commissioners win election.

During the same period, however, health district employees had received a 5.5 percent pay boost.

Now, noted county staff, for the just-ending FY 2012, SNHD was estimating a still quite-large year-end balance of 43.8 percent. And, for FY 2013, if it got the funding it wanted from the county, the district’s ending-fund balance would be a more-than-ample 28.8 percent.

For the elected commissioners, the budget report reminded them of all the reasons they’d lost patience with SNHD.

First to launch his salvos was Commissioner Lawrence Weekly, addressing Sands from the commission dais even before Sands had a chance to speak.

At first Weekly’s comments were opaque — seemingly aimed at reprimanding SNHD’s chief health officer without getting into specifics regarding what the reprimands were about.

“I will tell you as a former [commission-appointed board] member and an alternate [board member] of the Southern Nevada Health District board, there are a lot of hurt feelings. There are a lot of things that have taken place over at the health district,” said Weekly, mysteriously.

He then detoured into a paean to the health district’s importance as one of the community’s “first responders,” before circling back to complain, “But it’s in total disarray.

“It appears that things are still the way they were when I was on your board: just all over the place and crazy.”

Weekly, however, instructed Sands not to address the issues Weekly had just raised.

“I don’t want to hear about Scott, or the HR man — that’s not what we’re here about today,” said Weekly. “We’re here to talk about your budget, and how do we get you on point, get your employees back to their jobs and get the morale up over there, because it’s gotten to the point that it’s seriously despicable, right now. And it’s crazy.”

Weekly’s reference to “Scott” was to Scott Weiss, who until earlier this year was SNHD’s director of administration and Sands’ right-hand man.

At the Board of Health’s January meeting, evidence had surfaced that Weiss had been moonlighting as the administrator of a Las Vegas assisted-living facility. That, union officers insisted during the meeting’s public-comment period, was a serious conflict-of-interest offense.

Board members looking for direction on the charges were initially told by board legal counsel Annette Bradley that an investigation had been completed by Dr. Sands, and “it was determined that there was no conflict of interest.”

Board member Chris Giunchigliani, however, argued that the health district’s personnel code states an employee cannot oversee a business that is also regulated. And, she contended, the Plaza at Sun Mountain counts as a regulated facility because the health district could receive complaints about it. Bradley’s response was that “when management has made a decision that decision stands.” 

All the same, at the board of health’s next meeting, in February, Weiss was not present — having apparently been placed on administrative leave until the issue is fully resolved. 

Weekly’s reference to “the HR man” most likely referred to Angus MacEachern, the health district’s human-resources director. According to attorney Charles Pollock — affiliated with the SEIU officers who have been launching multiple charges against SNHD administrators — MacEachern, too, had been moonlighting.

“He has a job for one of the cities,” Pollock told Nevada Journal. “It may have been Boulder City. He’s a consultant for one of the cities’ HR department.”

In a June 6 interview, Pollock had predicted Sands’ departure.

“It looks like Sands is on its way out, one way or another,” he told Nevada Journal. “Whether he gets a buy-out of his contract, or something else, it looks like he’s leaving.

“And then, Angus has declared he’s taking early retirement in about three months. So you’re going to have a different managing group in there, probably with Dr. Middaugh ending up as the chief health officer. And that’s simply because he’s the only one there with an MD. You have to have an MD to be the chief health officer. So for at least a while, he’ll take it over.

“The question is,” said the attorney, “whether or not they decide to continue, with the attitude that, ‘Oh, 2013 is a new year, and we’re just going to run the place right from here’ — or they’re going to actually go back and figure out where the money was stolen, and go after it.”

Whether or not money is missing at the Southern Nevada Health District, however, is unclear. SEIU representatives have repeatedly insinuated malfeasance of various kinds, but evidence, so far, seems in short supply.

Union reps have asserted in board meetings that federal investigators are probing the district, focusing on alleged misappropriation of salary dollars.

Employees also contend that SNHD is now on the hook for a $352,000 electronic time-keeping system far more elaborate than the district needs. Additionally, before the Kronos Workforce Management system was selected, no competitive proposals were sought, Director of Administration Weiss acknowledged at the board’s Jan. 26 meeting.

At the same meeting, a supervisor in the district’s Environmental Health division, Susan LaBay, gave the board a devastating critique of the reportedly $2 million Decade EnvisionConnect remote-computing and data-management system that health-district management purchased.

She concluded her tightly worded and highly specific inventory of problems with the system by quoting “one of the individuals responsible for testing the field unit: ‘We cannot even test it yet, because nothing works. It is utter garbage.’”

According to Pollock, Decade Software has informed the health district that it cannot solve the system problems and is abandoning the project.

For more of the May 15 commissioner criticisms of Sands, see the accompanying story: Subtext: Listen, Sands, we're the big dogs here!.

Steven Miller is the managing editor of Nevada Journal, a publication of the Nevada Policy Research Institute. For more in-depth reporting, visit http://nevadajournal.com/ and http://npri.org/.

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