Ethnicity of O.C. Health Board Focus of Probe

The Orange County Board of Supervisors is the target of a federal civil rights investigation into allegations that it excluded Latinos from serving on the governing board of a new agency responsible for health care services to the county’s poor.

U.S. Department of Health and Human Services officials said the investigation was prompted by a complaint filed last year by local Latino leaders, who were angered that the seven-member board appointed to manage Orange County’s OPTIMA program lacked even a single Latino, even though several were recommended to the supervisors for consideration.

Since a “substantial number” of the estimated 300,000 county residents OPTIMA expects to serve will be Latino, officials with the League of United Latin American Citizens complained to federal officials that the supervisors’ appointment process “constitutes discrimination.”

In a Sept. 14 letter to LULAC in Santa Ana, federal officials stated they would investigate the charges, and advise LULAC of their findings.

“Finally, there will be public access to what we think is a very secretive and discriminatory process,” said Arturo Montez, president of LULAC’s Santa Ana chapter.

“The Board of Supervisors will now have to explain to the people of Orange County the process they use to appoint people for service on boards and commissions. I think we’ll find that those appointments are not a reflection of the electorate.”

Board of Supervisors Chairman Thomas F. Riley said Friday that he had not been notified of the investigation, but was “confident that the allegations were not true.”

“I spent a helluva lot of time on this process,” Riley said. “I don’t know of any other project on which I have spent more time. When we were reviewing candidates, I was not looking at nationality, or whether they were Catholics or Jews. I was thinking about who was the best qualified.”

Orange County Latino leaders first raised objections to the board’s ethnic makeup last August, when some doctors urged supervisors to review the selection process and add a Latino physician to the agency’s board of directors.

At the time, Dr. Robert R. Beltran sent a letter to supervisors in which he expressed outrage that none of the seven chosen for the OPTIMA board were Latino physicians experienced in working with the heavily Latino population of county Medi-Cal patients.

“This (OPTIMA) board will be overseeing (the provision of health care to) a populace which will be comprised of not less than 80% Hispanics,” Beltran wrote to the supervisors.

OPTIMA is designed as one of the country’s largest county health maintenance organizations. The system promises more efficient delivery of health care to the poor and depends largely on attracting the services of physicians by offering prompt and reliable payment--something doctors have long complained that Medi-Cal fails to do.

Supervisor Harriett M. Wieder, a prime backer of the OPTIMA experiment, could not be reached for comment Friday. However, she has previously indicated that Latinos “had the opportunity to participate, and they were not at the table.”

Of 128 people who applied for positions on the OPTIMA board, only three were Latinos, officials said.

Riley said Friday that he would stand by the board’s selection process and would not support any attempt to reopen the matter. Of the Latinos who did apply, Riley said he believed all were given “fair consideration.”

“It appeared to me that the process was open to any interested party,” Riley said. “If the process was reopened, I would think the current board members would have every right to object. In my opinion, there could not have been a more fair evaluation.”

Officials with the federal Department of Health and Human Services’ Office for Civil Rights declined to comment Friday on the letter acknowledging its intent to investigate the selection process.

LULAC’s Montez, however, said the supervisors’ process of selection amounted to a “policy of exclusion” for Latinos.

“When we first came forward with our concerns about this,” Montez said, “they took a very hostile attitude.”

How New Health Plan Works

The OPTIMA Plan, targeted to go into effect in mid-1995, will replace Medi-Cal benefits and is expected to serve more than 250,000 people in Orange County. The plan at a glance:

* Eligibility: Those who qualify for Medi-Cal will be eligible for OPTIMA.

* Managed care: As in a health maintenance organization, patients will be assigned a primary care physician, who in turn will refer them to specialists.

* Patient contribution: Will depend on ability to pay, as with Medi-Cal.

* Doctor fees: Primary care physicians will receive a flat monthly fee per patient seen, regardless of the number of patient visits. Fees have not yet been established. Under Medi-Cal, doctors are paid by the state after treating each patient.

* Funding: Medi-Cal is expected to allocate more than $450 million to OPTIMA to start with, about the same as Medi-Cal costs in 1991.

Source: County of Orange; OPTIMA; Researched by KEVIN JOHNSON and APRIL JACKSON / Los Angeles Times