Analyst Urges Release of Health Agency Criticisms

The state legislative analyst is calling on the California Department of Health Services to immediately release two reports that criticize how Los Angeles County has carried out promised reforms in its public healthcare system.

The nonpartisan legislative analyst’s office, which lawmakers turn to for neutral advice, urged the Legislature last month to withhold a total of $29 million from the state health department and L.A. County until the reviews of fiscal years 2001 and 2002 were publicly released. The state health department commissioned the studies and controls their release.

The first drafts of the reports, each hundreds of pages long, were completed in December 2003 by the consulting firm PricewaterhouseCoopers. They examine whether the county fulfilled the public health reform promises it made to the federal government in 2000 in exchange for an extra $900 million in funding.

The county pledged to expand access to outpatient health services and to enroll more residents in Medi-Cal and other public health insurance programs, among other things. The reviews conclude that the county met some goals but did not meet others, according to drafts obtained by The Times.

The state health department had told the legislative analyst’s office that the reports would be released last month, but they were not.

“Why it’s taken so long, we don’t really understand,” said Dan Carson, director of the health services section in the analyst’s office.

Lea Brooks, a spokeswoman for the state health department, said the reports were in their final review and should be released in the “next few weeks.”

“It’s a complicated, comprehensive report, and it’s taken a long time to prepare,” Brooks said.

The state spent $6.7 million on the reports, she said.

John Wallace, a spokesman with the county Department of Health Services, said the county had met all timelines for responses set by the consulting firm and the state. The county submitted its final response in January.

County officials have been highly critical of the reports, saying that PricewaterhouseCoopers was not objective and that its findings are wrong.

“The report appears to be designed in many respects to place the county in an unjustifiably negative light,” wrote Dr. Thomas Garthwaite, director of the county Department of Health Services, in a memo to the Board of Supervisors in December.

“While the department welcomed this audit at its outset and looked forward to using the findings to improve its healthcare delivery system, DHS now believes this audit is fundamentally flawed and has no value,” Garthwaite wrote in the memo, obtained by The Times.

State Assemblyman Mark Ridley-Thomas (D-Los Angeles) said he has tried since last year to have the studies released publicly. The reports were all the more important, he said, because the county health department estimates that it will face a $1.3-billion cumulative shortfall in 2008-09. The $900-million federal infusion spread out over the past five years runs out this June.

“You can’t fix a problem, nor are you inclined to fix a problem, if you think there’s nothing to be fixed,” said Ridley-Thomas, who heads a special Assembly committee looking at the county’s healthcare crisis. “All indications are [that] ... the crisis is worsening, and furthermore, the ball is being hidden.”