Pay Attention to the Dotted Line

To keep public services running smoothly and crises to a minimum, Los Angeles County needs a contracting process in which department heads and other bosses are held to well-defined standards that are overseen without favoritism by county supervisors. This is not nanotechnology.

A current case in the news involves a now-closed and bankrupt group of for-profit medical clinics, the Metro South Provider Network, whose clinics were under contract with the county to provide outpatient care for uninsured people. Not only did the network close while owing the county nearly $779,000 for low-cost pharmaceuticals that the county had provided, but health care for patients in southern and central Los Angeles County has now been interrupted. Those patients are scrambling to find other facilities in a long-underserved area.

The situation is murky, but it appears that the five clinics in the network, largely staffed by doctors associated with the county’s Martin Luther King Jr./Drew Medical Center, were being kept afloat through an allegedly illegal deal allowing them to purchase drugs at a steep discount through a federal government program designed to help public medical facilities like the Veterans Administration and county clinics, not private doctor groups like Metro South.

County health officials did not have a contract to provide drugs to Metro South, making this the fourth time in a little more than two weeks that various county departments have been caught running programs without written contracts.

“It’s something that’s getting out of hand,� said Supervisor Gloria Molina, who chided county Sheriff Lee Baca for bringing another contract irregularity, a $4-million retroactive agreement, to the board last week. Molina blames cavalier county bureaucrats, but this is not an issue that began two weeks ago. Lax oversight has marked other county health issues, including problems a few years ago with excessive private-practice moonlighting by county-salaried doctors.

Bureaucrats, no matter how intransigent, are not the whole problem. The leadership to bring order and transparency to county contracts has to start with the Board of Supervisors.