Los Angeles County is taking many of the right steps to prepare for a potential bioterrorist attack but needs to do a better job justifying how it spends grant money, federal officials have found.
Reviewers from the U.S. Centers for Disease Control and Prevention visited the county's terrorism readiness program in May, two months after The Times reported that the health department spent at least $2 million in federal grant funds for items that were of questionable relevance.
The CDC officials, in a report issued last month, complimented the county for working with other public agencies and private groups in its preparations. The agency also praised the county's efforts to track patient visits to emergency rooms so officials can quickly spot unusual diseases or illnesses.
But the CDC said the county had sometimes misinterpreted federal spending and budget policies. "This has resulted in delays and multiple efforts to correct information provided," the document said, causing "major roadblocks to performance."
Since 2002, the county has received about $110 million in federal grants for bioterrorism planning. Because of the county's formidable size and risk as a terrorist target, it gets its money directly from the CDC, as do New York City and Chicago. Allocations for all other counties in California flow through the state Department of Health Services.
The CDC has not asked L.A. County to return any of its money. But agency senior advisor Donna Knutson said "we came to an understanding that in the future we would expect more details to be provided so that conversations and clarifications would occur before purchases are made."
The CDC report follows two earlier audits of the county's bioterrorism program that raised concerns about spending and other administrative issues.
The county Board of Supervisors requested one of the audits in March after The Times reported that bioterrorism grants to the county had been spent on buffing up the health department's image, responding to unrelated health scourges and buying questionable supplies and services.
For example, the county spent $57,045 to hire extras from Central Casting to participate in a 2004 smallpox vaccination drill, along with gift bags to thank the paid actors and volunteers. The county also spent $128,000 on promotional items to be given away to the public, including letter openers, whistles, magnets, mouse pads, flashlights, pens, travel toothbrushes and emergency kits.
In April, the county auditor-controller said public health officials should better justify "unusual or potentially sensitive purchases."
The CDC recently informed its grant recipients that they should not use federal funds to purchase promotional items, Knutson said.
Separately, the county public health department asked four outside experts to review the bioterrorism program. Their report, released in May, said officials had made "considerable progress since 2001 and are to be applauded for a strong and solid preparedness effort."
But the team also found that the county bureaucracy has created problems in "timely and appropriate" hiring, purchasing and oversight. It was sometimes unclear who was in charge of what, the group said. And while the county had sought to raise public awareness of preparedness with a marketing campaign, it made "uneven progress" with minority and non-English speaking groups.
County officials say they have taken the advice to heart and are doing a better job explaining their spending requests to the CDC.