The scathing report on Orange County’s $1.5 billion managed care system for the poor, CalOPTIMA, highlighted the departure of 16 senior executives from the organization and what can best be described as a hostile and manipulative level of interference by the lone County Supervisor on its board, Janet Nguyen. Yesterday, Supervisor Nguyen held a press conference to rebut the assertions in the Grand Jury report. Her press conference followed her release of an Op-Ed in the Orange County Register titled “An incomplete critique of CalOptima”.
The Grand Jury is limited in its investigative effectiveness by the lack of knowledge of individual members of the panel, and staff that are not necessarily schooled in the intricacies of the issues they investigate. This isn’t to say they (the Grand Jury) always get it wrong, rather that they sometimes don’t get the story 100% right. Supervisor Nguyen mad a mistake yesterday in focusing on only what they got wrong, and not what they got right. This provides the perception of an elected official struggling to save her political career rather than an elected official accepting criticism while setting the record straight. If Supervisor Nguyen wants the public to believe the entire grand jury report was in error, she’s going to have a tough time getting people to believe her.
At the core of Supervisor Nguyen’s credibility gap is the matter of the fundraiser held on her behalf by hospital interests two months after her “reform” initiative granted them a permanent seat on the CalOPTIMA Board. Had the same event been held a a year later the change would not look like a case of transactional politics.
It is the departure of a large portion of agency management that concerns us most. This seems to be indicative of board member interference in the day-to-day operations of the organization. This type of manipulation can easily occur when one super-influential or powerful board member starts messing with operations instead of policy.
The role of any board governing a public agency is to make policy decisions that guide the operations and then leaving the management to the professional staff. Supervisor has a reputation of digging into the operations side of things and inappropriately ordering staff around like she runs the place. In her entire career she has never once been challenged to stop her interference by her elected colleagues.
That is why we believe that the first step the Board of Supervisors should take is to include all members of the Board of Supervisors on the CalOPTIMA board. Their first order of business should then be to set policies that separate the board from direct interference in operations. Cal OPTIMA’s board should direct the CEO. If they don’t like the CEO’s performance they should change the person in that position.
With the full Board of Supervisors sitting on the CalOPTIMA board, the ability of a single Supervisor to run through the agency like a Tasmanian Devil will be limited. This will provide the stability the agency needs to attract new professional managers to operate the organization.
From a Voice of OC article on the Grand Jury report:
In addition, the Grand Jury details how a confidential report to the CalOptima board was distorted to falsely make it appear there were serious problems within CalOptima’s management. The section of the report then was leaked to the Orange County Register.
The findings of the report, titled “CalOptima Burns While Majority of Supervisors Fiddle,” include the following:
- A “CalOptima board member (Nguyen) and two CalOptima (staff) lawyers have been disruptive and created an atmosphere that according to current and former CalOptima employees is ‘unsafe for senior executives.’” Sixteen top executives, including the CEO, chief financial officer, chief medical officer and chief operating officer, have left CalOptima since Nguyen began remaking its board of directors.
- “Member organizations have expressed fear of retaliation if they do not support certain (unnamed) causes or candidates and the Board of Supervisors majority has not attempted to curtail or dispel these fears.”
- An unidentified CalOptima board member privately stopped staff from hiring an outside law firm to investigate allegations against four board members, even though the board had voted unanimously to hire the firm.
- “Several current CalOptima Board members and recent hires lack the healthcare experience to understand the complexity of CalOptima as proven by their comments and questions during CalOptima Board meetings.
- A majority of the five supervisors “failed to take an active role in preserving (CalOptima) an entity playing a vital role in the healthcare needs of the County’s young, disabled, low income and senior residents.” It also blamed a majority of the supervisors for allowing the top CalOptima executives to leave.
- The decision by the current CalOptima board to seek a total of $90,321 from two former board chairmen, Ed Kacic and Michael Stephens, “had all the earmarks of retribution by the retooled Board of Directors against the Chairmen for fervently opposing the ordinance change.
“Supervisors should change the CalOptima board of directors to include more than one supervisor and remove the two county employes, the directors of the Health Care and Social Services Agencies. Employees have to report to the county’s CEO and are too likely to be intimidated by a supervisor, the report said. All five supervisors serve on the Orange County Transportation Authority board even though it handles less taxpayer money than CalOptima.