Battling Over Control of AIDS Clinic : Health: Officials say director had too much independence, too little accountability. He says he is unfairly being singled out.

By JOSH MEYER

Dec. 10, 1995 12 AM PT

TIMES STAFF WRITER

As a prominent infectious disease specialist, Dr. Wilbert C. Jordan was one of President Clinton’s guests Wednesday at the first-ever White House conference on the war against AIDS.

Here at home, however, Jordan is quietly fighting another, much less public, battle--who controls the Oasis AIDS clinic he founded at Martin Luther King Jr./Drew Medical Center near Watts.

In recent months, hospital administrators have tried to rein in Jordan, in part over what they say is the extraordinary amount of independence and lack of accountability he has had there. But their efforts, officials confirmed, also were prompted by troubles at the clinic and by problems Jordan has had with the Medi-Cal system. Those problems started with his 1987 guilty plea to federal misdemeanor fraud charges stemming from activities at his private practice and led to $250,000 in rejected reimbursement claims at the clinic.

The county never disciplined Jordan for that conviction, but suspended him for 30 days without pay after the quarter-million-dollar loss was discovered, according to Civil Service Commission records.

For most of the past eight years, Jordan was banned from treating Medi-Cal recipients--the vast majority of King/Drew’s patients--and from writing their prescriptions, which is the cornerstone of treating those who have contracted the human immunodeficiency virus that causes AIDS.

But Jordan remained as clinical director with a $100,000-plus annual salary, and kept on treating patients and writing prescriptions--at times with the knowledge and cooperation of his superiors, he said. He was not penalized for that either, until hospital officials were told by the state that his actions had cost the debt-ridden county Department of Health Services as much as $250,000 in rejected Medi-Cal reimbursements for prescriptions, documents show. Though some officials urged that he be fired, Jordan was suspended last year for 30 days.

When asked for comment about the case, top county officials and health department investigators said last week that they were never told about Jordan’s problems.

And now they want to know why.

“There are an awful lot of unanswered questions,” said Fred Leaf, head of the health department’s Audit and Inspection Division.

Leaf and other officials, including county Chief Administrative Officer Sally Reed, said Jordan’s case heightens their concerns that the beleaguered hospital, and the health department in general, are not adequately policing or disciplining their doctors and administrators. Recently, top health officials first learned from a reporter that a King/Drew psychiatry clinic administrator had been convicted of felony Medi-Cal fraud at his private practice nearly four months ago, but remained on the staff at $102,000 a year.

That psychiatrist, Dr. Buford Gibson Jr., resigned Dec. 1, a day after The Times reported that he had been sentenced to serve two years in a halfway house and pay $500,000 restitution.

“It’s very alarming,” Reed said. “It’s clear we will have to work with the [health] department to put some procedures in place to ferret out problems like [these] and take appropriate action.”

Leaf, the health department’s chief investigator, blamed King/Drew officials for not bringing either the Jordan or Gibson cases to him or top department administrators, including then-Health Services Director Robert C. Gates. “This . . . shows we should have had a system in place,” Leaf said.

Leaf and other county officials are now contacting local, state and federal authorities to set up a reporting system so they can get early warnings about doctors suspected of running afoul of the law.

Top health officials also have quietly launched a review to see if any other “problem” doctors are on the payroll. And they are trying to determine how and why Jordan was allowed to continue running the Oasis, the only major county AIDS outpatient center in South-Central Los Angeles.

Investigators have asked the hospital for a tally of Jordan’s prescriptions denied by the state, especially because some hospital administrators now contend that they do not know how much money Jordan’s actions cost the hospital. “At this point,” Leaf said, “they don’t even know if they got paid or not.”

One memo, however, said Jordan’s actions placed the health department “in the untenable position of having to accept a loss . . . of $250,000. This is a position that no public agency, operating with public monies, should be asked to endure.”

In interviews, Jordan said he is being unfairly singled out for blame for trying to run the AIDS clinic when no one else would. He argued to the Civil Service Commission that his superiors knew all along what he was doing and even co-signed some paperwork in an effort to help circumvent the suspension. Health officials deny that, and cite a Civil Service Commission hearing officer’s conclusion that Jordan ignored orders to stop treating patients.

Jordan said Medi-Cal reimbursed the hospital for his treatment of patients because the forms were co-signed by his superiors and that the only reimbursement claims rejected were for about 2,700 prescriptions he alone wrote. It was only after those claims were rejected, he said, that his supervisors turned on him and began “trying to cover their butts” by claiming he acted against their orders.

“No one in the hospital gave a damn about AIDS patients except myself,” Jordan said recently. “We all made a mistake. I won’t accept being [made] a scapegoat.”

An outspoken and at times controversial physician, Jordan is a former chairman of the Los Angeles County AIDS Commission and current chairman of the Black Los Angeles AIDS Commission. Jordan described his legal problems as “a nightmare,” and said he never would have pleaded guilty to fraud charges had he known he would be barred from treating Medi-Cal patients.

The charges involved about $14,000 that Jordan billed Medicare for hospital care and office visits when he actually called patients by phone or saw them at home.

Jordan sought to vacate his guilty plea to the federal charges, but his appeal was denied, and he is now taking the request to a higher court. “It’s a procedural morass,” his lawyer, Brian Sun, said. Earlier this year, Jordan’s Medi-Cal eligibility was reinstated, retroactive to September 1993, he said.

In the intervening years, Jordan said, he was forced to help treat some of the 50 AIDS patients that came to the clinic each day because there was no one else around to do it. Hospital officials, in fact, testified at his Civil Service hearing over his suspension that the clinic would at times be closed when Jordan wasn’t there, prompting AIDS patients to seek treatment in the emergency room.

After hearing lengthy testimony from nurses, doctors and administrators, hearing officer Terri Tucker concluded that emergency room personnel “would often keep a patient until [Jordan] returned to treat the patient,” sometimes several days later.

Although Tucker described Jordan’s dedication to his clinic and AIDS patients as “rare, wonderful and heroic,” she upheld the suspension, concluding that he ignored orders. Not only did he subject the hospital to the loss of the $250,000, she said, he risked “hospital-wide loss” of health care funding.

At the hearing, the former head of outpatient care at King/Drew, Jeffrie Miller, and other administrators said that other doctors could have taken over Jordan’s patient care responsibilities and that he repeatedly ignored their orders to stick to teaching and administrative duties.

“It was a constant battle between myself and Wilbert,” Miller, now assistant medical director at King/Drew, said last week. “It wasn’t just a couple of months that we went through this.”

Jordan’s case helped prompt administrators to reorganize the clinic and add some accountability, Miller said. In addition, county auditors released a critical report of the clinic this year, citing it for having haphazard patient records.

In the past two months, Jordan has been told to report to the chief of immunology, who must in turn report to the head of internal medicine. He also has been told to let go three part-time doctors and replace them with one full-time staffer.

Now, Miller said, “There is much tighter medical supervision.”