In the wake of a “pay to play” state fine raising questions about Orange County’s health care plan for the poor, state legislators are now considering banning county supervisors like Andrew Do from working for the agency in the year after they leave office.
The legislation is now set to come up for final legislative approval in the coming weeks, according to its lead author, Assemblywoman Sharon Quirk-Silva (D-Fullerton).
Quirk-Silva, who is leading a bipartisan coalition of Orange County’s state lawmakers that have cosponsored her bill, describes the effort as providing “key guardrails to protect against the further politicizing of CalOptima.”
Last month, state regulators fined Do $12,000 for violating “pay to play” laws by using his CalOptima board position to try to push through lobbying contracts for two of his campaign donors.
In December, Voice of OC revealed that Do has been growing his influence at the health plan – triggering concerns from local health care leaders and state legislators about the politicization of CalOptima, which provides health insurance for 850,000 of Orange County’s poorest residents.
A few months later, the bipartisan group of legislators backed a bill to curb the influence of county supervisors like Do.
Do didn’t return phone calls, emails and text messages asking for his take on the legislation.
The bill, AB 498, would ban Do and any other county supervisors serving on CalOptima’s board from working for the health plan for one year after leaving office.
It also bans them from lobbying CalOptima, and even stops them from working for any organization that receives federal health dollars from CalOptima.
Quirk-Silva calls it a basic “good government” move to prevent “revolving doors.”
“My bill is not looking at singling anyone out – it is focused on potential conflicts, checks and balances, ethical standards,” Quirk-Silva said in a text message to Voice of OC.
The state Senate Health Committee staff analysis of the bill cites Voice of OC’s “stories on troubling hiring practices suggesting nepotism” at CalOptima and OC Register coverage of Do and others approving a sharp jump in executive salaries at the agency.
Last year, as CalOptima’s chairman, Do presided over major pay raises for the agency’s executive positions – including raising the CEO’s maximum base salary from $600,000 to $765,000.
CalOptima has increasingly been placed in the hands of Do and one of his longtime top aides, Veronica Carpenter, who moved from Do’s county office to the health plan last year. Voice of OC revealed that in an article last December.
Carpenter had less than a year of professional experience in healthcare administration when she moved into a newly-created chief of staff role at CalOptima, which was set to pay $282,000 plus benefits as a top advisor to the CEO.
Voice of OC’s coverage prompted a Register editorial raising deep concerns about CalOptima, calling Do’s maneuvers “the politicization of a vital government program” that local healthcare leaders are right to “raise alarm bells” about.
So far, the bill been sailing through legislative committees with unanimous votes, and has support from several major medical associations, according to legislative records. No groups have opposed it so far, according to the legislative staff analysis.
CalOptima is Orange County’s largest health insurer, managing the publicly-funded medical coverage of 850,000 low-income children, adults, seniors and people with disabilities.
That’s one in every four residents and one in every three children.
CalOptima used to be considered one of the best-run medical plans in the state. Previous federal audits found no major problems.
It was set up in the mid-1990s by a coalition of leaders seeking to bring community control to the federal health coverage funded by Medicare and Medicaid.
For years, county supervisors had little interest in serving on its board.
But changed about a decade ago.
That’s when in 2011, Do’s former mentor, state Assemblywoman Janet Nguyen, reshaped CalOptima’s board while she was an elected county supervisor.
A grand jury later described it as a decimation of the agency’s professional leadership while she fundraised from a lobbyist she let re-write CalOptima’s governing rules.
As part of that takeover, CalOptima’s leaders were replaced with people who lacked experience and didn’t understand the complex agency, the grand jury found.
After the takeover and chaos described by the grand jury, federal auditors found massive mismanagement and errors at CalOptima.
That posed a “serious threat to the health and safety” of patients, auditors found. Federal officials went so far as to order CalOptima to stop enrolling elderly people in the program.
The “widespread and systemic” failures included improperly denying prescriptions that were covered by the plan, refusing to pay for emergency services, not paying medical providers on time and not allowing patients and doctors to appeal denials of coverage.
Nguyen left CalOptima’s board in early 2014 after winning a campaign for state Senate.
Later, after the federal intervention, state auditors said the following year they were impressed with improvements the agency made.
Do was elected supervisor in 2015, and soon after he Nguyen had a severe falling out after – a rift that continues to this day.
Years later, Do tried to become CalOptima’s chairman, but failed to garner enough support from his board colleagues to do so.
After that, he unsuccessfully led an attempt to have the board of supervisors take over a majority of the CalOptima board.
In 2020, Do finally succeeded in his aim, convincing his CalOptima board colleagues to make him the health plan’s top board member as chairman.
Nick Gerda covers county government for Voice of OC. You can contact him at ngerda@voiceofoc.org.