An effort by Orange County supervisors to take control of the county’s health plan for nearly 800,000 low-income county residents appears to have died, after a change approved Tuesday that allows state legislators to block it before it takes effect.

And in a public rebuke, one of Supervisor Andrew Do’s colleagues said Do has been pushing for the CalOptima takeover because the health plan’s board refused to elect him chairman.

Supervisor Todd Spitzer said he’s unhappy with state officials moving to tie supervisors’ hands over CalOptima’s board structure. But, he said, Do brought it upon himself.

The state intervention is “a path that got carved because of other positions this board has taken, and other things that have happened with respect to the leadership fight at CalOptima,” Spitzer said at Tuesday’s supervisors meeting.

“Supervisor Do should be the chair of CalOptima,” Spitzer said, turning to address Do. “But when you lose that vote, you’ve got to then move on, and pack up your tent, and then fight another day to be the chair in the next rotation.”

Do didn’t dispute that his takeover effort was motivated by being rejected as chairman.

Instead, he thanked Spitzer for his remarks and emphasized why he should have been chosen as chairman.

“Thank you for your comments earlier and your support [of] my desire to be chair of CalOptima. It was just based on my – as everyone who follows the board knows, I care deeply about the homeless, about mental health, about health care,” Do told Spitzer.

“If there’s one person who has taken on a lot of issues in those areas in the last two and a half years since I’ve been on this board, I think I would like to say I’m probably one of those people.

“And so, with the coordination that is coming down as a policy from the federal and state government, I just thought that, with all of my work, that I would be a good person to coordinate the information between the county and CalOptima.”

The original proposal by Do and Supervisor Michelle Steel to remake the CalOptima board of directors would have put all five  supervisors on the board, instead of just the two who currently serve. The move would have given the supervisors and their subordinates at county agencies a controlling majority on the board, and required the rest of CalOptima’s board members to re-apply to stay on.

But Supervisor Shawn Nelson, whose vote is needed to make the changes, partially scaled back the measure on July 11, and made further changes Tuesday that effectively killed the measure.

Nelson’s latest change, which was passed by himself, Do and Supervisor Michelle Steel, delays implementation of the CalOptima changes until Jan. 1, the latest date that a state bill blocking the supervisors’ efforts would take effect.

The bill, which is now pending on the Assembly floor, received unanimous bipartisan support from both of the Assembly committees that reviewed it.

“There’s no purpose served by trying to put something into effect, only to have it taken right back on January 1st,” Nelson said.

Nelson said he still supports putting all five supervisors on the CalOptima board.

“But what I don’t support is some circumstance where we try to reconstitute a board – it’s the middle of summer, you kind of throw a bunch of turmoil into an agency that’s trying to do its job – and then potentially in January we suddenly have” a new state law taking CalOptima back to the current board structure.

The takeover attempt was introduced earlier this month by Do and Steel, who argued that replacing current board members with all five supervisors would increase local elected representation on the board.

Do and Supervisor Lisa Bartlett remade the CalOptima board a year ago, replacing a number of board members who were appointed when former Supervisor Janet Nguyen and a lobbyist for the Hospital Association of Southern California (HASC) remade the CalOptima board in 2011, giving control to the medical industry.

The medical industry retained a strong presence under the Do-Bartlett remodel. Do used to be a top aide to Nguyen, but the two later had a serious falling out. Nguyen, of Garden Grove,  now is a Republican state senator.

The fast-tracked effort by Do and Steel this month to again remake the CalOptima board sparked deep concern among groups representing doctors and other medical providers – including local hospitals, health clinics, and the Orange County Medical Association – who are strongly represented on the current CalOptima board.

With their support, state Sen. Tony Mendoza (D-Artesia) has been quickly moving a bill through the Legislature that would block the supervisors’ effort by enshrining the current CalOptima board structure in state law. Mendoza’s district includes the OC city of Buena Park.

County staff said the bill, SB4, is expected to receive a vote by the full Assembly after legislators return from summer recess on Aug. 21.

It would take effect on Jan. 1, but county staff say it might be changed to an “urgency” bill that would put it into effect immediately after it’s signed by Gov. Jerry Brown. Spitzer said he’s “positive” both will happen.

The state bill would override any changes made by supervisors, because state law trumps county law.

Two of the five supervisors – Spitzer and Bartlett – have staunchly opposed changing the CalOptima board structure, saying there’s no compelling problems to justify altering the current system. That left Nelson as the deciding vote for what happens to Steel and Do’s proposal.

The supervisors’ action Tuesday to increase their presence on CalOptima’s board – and delay implementation until January – will come back for a second and final approval at an upcoming meeting.

Do, meanwhile, took aim Tuesday at a prominent fellow Republican for criticizing his effort to restructure the health plan’s board.

Carolyn Cavecche, a former Orange mayor who is now president and CEO of the Orange County Taxpayers Association, wrote in an Orange County Register opinion piece this weekend that Do and Steel’s effort was “political posturing that is risking the stability of this complex organization.”

“[CalOptima’s] $3.4 billion budget — and 800,000 lives — depend on stable, knowledgeable oversight, not political theatrics,” Cavecche wrote. The taxpayers association she leads is sponsoring Mendoza’s bill to keep CalOptima’s board the way it is.

Do said her description of “theatrics” was “just self-serving and disingenuous.”

“That statement by Ms. Cavecche is beyond ignorant,” Do added.

Spitzer, meanwhile, said it was fair for state legislators to question Do’s efforts to restructure the CalOptima board just a year after the last restructuring.

“You can’t make people’s heads spin like this in the world of public policy, and expect them to stay on the same page as you,” Spitzer said..

“You can’t blame the policy makers in Sacramento for saying, ‘What the hell is going on in Orange County? What is that board [of supervisors] doing?’ ”

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

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