The CalOptima board of directors Thursday night rejected OC Supervisor Andrew Do’s bid to become the first supervisor to chair the county’s public healthcare plan.

Do suggested his “ethnicity” had a role in opposition to him, saying the board’s vice chairman unfairly compared him to his former boss, Janet Nguyen. Nguyen preceded Do as a county supervisor on the CalOptima board and now is a Republican state senator from Garden Grove. The two, however, had a major falling out after Do was elected in 2015 to succeed her.

But CalOptima Vice Chair Lee Penrose, chief operating officer of the St. Joseph Hoag Health hospital group, said ethnicity had no role in his thinking, and told board members a doctor should be chairman during coming months as Pres. Donald J. Trump and Congress remake or repeal the nation’s Affordable Care Act.

He said his comment in a telephone conversation with Do earlier Thursday “was never intended to be ethnic,” and “I apologize if it came out wrong, or if it struck a nerve.” Penrose said he simply was concerned about having a supervisor serve as chair.

CalOptima manages the healthcare of 800,000 low-income Orange County children, adults, seniors, and people with disabilities. Its $3.4 billion budget comes primarily from federal and state funds.

The county Board of Supervisors appoints CalOptima’s 10-member board of directors, but no supervisor has been elected chair in its 21-year history.

Do was challenged for the chairmanship by Dr. Paul Yost, an anesthesiologist who is also on the board of the Orange County Medical Association. Yost was elected chair on a 6-3 vote. Although the board has 10 members, current Chairman Mark Refowitz, head of the county Health Care Agency, is a non-voting member.

Both Do and Yost gave speeches about why they were the best choice for chair – with Do emphasizing he represents half of CalOptima members as 1st District supervisor, and Yost noting his relationships with the medical community and political experience as a former Seal Beach councilman.

Then Penrose spoke in favor of Yost.

He acknowledged Do’s accomplishments, such as strengthening the board last year through a re-structuring, but said in a time of likely reductions in funding, it was important to have a physician as chair.

CalOptima has some “tough times ahead of us,” given proposed cutbacks to funding under the Affordable Care Act, and the agency will need to engage with doctors, said Penrose.

But Do said it was wrong for Penrose to speak in favor of a candidate, although Refowitz said it was CalOptima policy to let all board members speak.

Do accused Penrose of presiding over “mismanagement” at CalOptima and being biased against Do’s Vietnamese-American ethnicity.

Penrose, he said, served as chair leading up to a scathing federal audit that found a serious threat to the health and safety of about 16,000 people receiving care under a specific CalOptima program.

That audit was a “black mark” on CalOptima and revealed “mismanagement that happened under your watch,” said Do.

And Do said Penrose, in a phone call earlier Thursday, expressed concern about having a supervisor serve as chair. It was an apparent reference to Nguyen’s tenure, which created a major upheaval at CalOptima beginning in 2011.

She and the then-lobbyist for the Hospital Association of Southern California (HASC) redesigned the CalOptima board to give the medical industry increased control, according to a grand jury report. That board largely did what Nguyen suggested. Nguyen raised more than $100,000 in campaign contributions from the medical industry, as has Do, according to records on file with the Orange County Registrar of Voters.

After he was elected as Nguyen’s successor on the Board of Supervisors, and after he and Nguyen had their falling out, Do and Supervisor Lisa Bartlett, who also is on the CalOptima board, remade the board. Do repeatedly said he wanted the new board to speak out on issues and be more involved.

In response to his phone call with Penrose, Do told the meeting, “there have been five supervisors (over the years) on this board,” and yet “I am singled out” as being like the one of “my own ethnicity.” Do added “in no way” has he conducted himself like Nguyen.

“To me this is very improper advocacy,” he said.

Penrose said ethnicity had no role in his thinking.

Board members then cast their votes for chair, by holding up yellow cards for Yost and blue cards for Do.

Board members cast their ballots for chairperson. (Photo by Nick Gerda/Voice of OC)

Most of the six who voted for Yost work in the medical industry. He was supported by himself, Penrose, Ria Berger, Ron DiLuigi, Dr. Nikan Khatibi, and Dr. Alexander Nguyen.

Voting for Do were himself, fellow Supervisor Lisa Bartlett, and Scott Schoeffel, who served with Bartlett on the Dana Point City Council.

Most of the board members joined the board in August, after Do and Bartlett led the its re-structuring. As he was preparing the re-organization, Do said wanted the new board to be “more engaged” and “independent.”

A new chairperson had to be chosen because Refowitz is retiring at the end of March. The new chair fills out the rest of Refowitz’ term, which ends in June.

Refowitz was thanked by his colleagues for injecting humor and institutional knowledge into the board meetings.

“It has been a true honor to serve on this board,” an emotional Refowitz said toward the end of the meeting.

In the aftermath of the critical 2014 federal audit, CalOptima officials say things have turned around.

Nick Gerda covers county government and Santa Ana for Voice of OC. You can contact him at

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