California Governor Jerry Brown has effectively killed efforts by Orange County supervisors to take control of the board of CalOptima, the county’s $3.4 billion health plan for low income and elderly residents. 

Last Wednesday, Brown signed Senate Bill 4, which was introduced by State Sen. Tony Mendoza of Artesia and enshrines the existing make-up of the CalOptima board in state law, effectively blocking local attempts to restructure the board.

The bill, which takes effect immediately, is a rebuke of an attempt by county supervisors this summer to assert control over the board by restructuring it to include all five supervisors, instead of the two who currently serve.

Supervisors Andrew Do and Michelle Steel argued the changes would increase local representation on the board.

Do’s effort to remake the board was reportedly fueled by his anger after the current CalOptima board refused to name him chairman in March.

CalOptima’s board had already been restructured twice since 2011, when then-supervisor Janet Nguyen and a lobbyist for the Hospital Association of Southern California remade the board enhancing the influence of the medical industry. Nguyen is now a Republican state senator.

A scathing county grand jury report in 2013 – called “CalOptima Burns While a Majority of Supervisors Fiddle” – blamed Nguyen’s actions for a disruptive environment that resulted in the departure of sixteen top executives. CalOptima spent much of 2012 and 2013 with vacancies in key positions.

The transition from the former board to a highly inexperienced one also occurred just as federal Affordable Care Act was taking effect and the agency was preparing for a major increase in members.

Later, a major federal audit in 2014 found widespread and systemic performance issues in the agency’s OneCare program, and ordered an immediate halt in enrollment of elderly patients into the program. Those sanctions were lifted in February 2015 and state auditors said they were impressed with the improvements made.

During her term on the board, Nguyen raised more than $100,000 from the medical industry, according to her campaign reports, and Do, who followed her as supervisor, raised a similar amount.

Do, a former top aide to Nguyen who has since had a serious falling out with the state senator, and Supervisor Lisa Bartlett restructured the board again in 2016, replacing a number of board members but maintaining a strong presence for the medical industry.

The Mendoza bill was sponsored by the Orange County Taxpayers Association and had the support of the medical industry, including the Orange County Medical Association and several local hospital chains, like St. Joseph Hoag Health, Tenent Healthcare and MemorialCare Health System.

OC Taxpayers Association president Carolyn Cavecche wrote, in a July opinion piece for the Orange County Register, that the latest attempt to restructure the CalOptima board was “political posturing that is risking the stability of this complex organization.”

Do called Cavecche’s statements “beyond ignorant” and also questioned the motives of the medical industry in sponsoring Mendoza’s bill.

“Now they are seeking to consolidate their power on the CalOptima Board by proposing legislation in Sacramento to take away local control,” Do told the Orange County Register in July. 

Contact Thy Vo at or follow her on Twitter @thyanhvo.

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