Cost is still big issue for an L.A. city health agency: Opinion

The battle between the AIDS Healthcare Foundation and L.A. officials continues to be as personal as a political fight between a giant international nonprofit organization and huge government bureaucracies can be.

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Worse, it continues to be more personal than an otherwise serious argument about protecting the well-being of millions of people should be.

Last week, Los Angeles County won a round in court when a federal judge turned down the AIDS Healthcare Foundation’s request for a temporary restraining order to halt a county audit of AHF.

AHF vowed to continue its fight against the audit, which is a follow-up to one that concluded the organization overbilled the county by $1.7 million for contracted services in the 2008-09 fiscal year.

AHF contends the new audit is an attempt at retaliation by the county for the group’s campaign to create a separate L.A. city health department, a plan that would gut the L.A. County Department of Public Health.

Which side is retaliating for what is part of the debate over the audits. But, really, the whole audits argument is a distraction from the central issue of whether an L.A. city health department would be a good idea.

By resisting what the county says is a routine, required audit, AHF is squandering credibility and wasting time better spent responding to criticism of its city health-agency plan.

There’s a lot to respond to. When AHF started its successful signature drive last winter for a June 2014 ballot measure to create a city health department, critics noted that one of the problems is the potential cost.

It was estimated that the health department would cost L.A. city $200 million a year. How could the city afford this in an era of tight budgets, when basic services were being cut back? Who would trust the protection of the public from disease, disaster and unsafe food and water to a government that can’t patch a pothole?

AHF replied that cost wasn’t an issue — the $200 million that the county health department currently allocates for the city would simply be transferred to the city department. The ballot measure calls for a city health agency to be created within 120 days of passage.

That sounds too simple, and it is. L.A. City Administrative Officer Miguel Santana reported to the City Council in June that operating costs for a separate city health department, minus the amount that could be offset by fees, would be $261 million a year; start-up costs were not included. Santana said the agency could take as long as two years to create.

Referring to the city’s ongoing budget deficits, Santana said passing the initiative would “increase the overall shortfalls the city has to address.” The council rejected the plan but was compelled by the petition signatures to allow it to go on the ballot.

AHF President Michael Weinstein, who accuses the county health department of cronyism and says a city agency would be more effective, told our reporter Rick Orlov he wants a broad-ranging discussion on health care in L.A. Yes, that’s a very good idea.

If AHF wants to lead a serious debate about the well-being of Southern Californians, it should stop fighting side battles against audits and start making a better case for what so far sounds like a costly and overly optimistic health-department proposal.

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2 Responses to "Cost is still big issue for an L.A. city health agency: Opinion"

  1. Michael Whiteacre   July 25, 2013 9:18 pm at 9:18 PM

    Some background:

    AHF accuses L.A. County of ‘retaliatory’ audit

    http://www.dailynews.com/news/ci_23690366/aids-healthcare-foundation-accuses-l-county-retaliatory-audit

    …In which the man who drove adult performers’ health clinic out of business through constant harassment and the filing of frivolous suits and complaints, bleats, “You can maim or kill a program by constantly auditing it. Our staff has a right to take a vacation.”

    “The devotion by AHF staff of additional time during July and August…is highly likely to have a deleterious impact on the health of some AHF patients,” the foundation said in its request for a temporary restraining order.

    The following day, US District Judge Percy Anderson REJECTED AHF’s bid for a temporary restraining order to delay the audit because it could not back up its claim that the audit was a form of harassment that would harm patients.

    “Even plaintiff’s evidence of irreparable harm is relatively weak in light of the county’s evidence that the type of fiscal audit it plans ordinarily does not interfere with the delivery of patient care,” Anderson wrote.

    Weinstein vowed to fight on. “We will continue to press this case about retaliation and our Fourth Amendment rights,” he said.

    The man who created and financed Measure B — a law which empowers government agents to enter private property without a warrant OR probable cause, to inspect the genitals of consenting adults engaged in legal, constitutionally protected behavior — is complaining Fourth Amendment rights!!!

     
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  2. Michael Whiteacre   July 25, 2013 9:21 pm at 9:21 PM

    Daily News: L.A. County wins this round against AIDS Healthcare Foundation

    http://www.dailynews.com/health/ci_23696963/l-county-wins-this-round-against-aids-healthcare

    Weinstein said the county should give the AHF some “breathing room” and postpone the audit until September.

    The federal judge, however, said there was an “absence of sufficient evidence, as opposed to allegations,” that conducting the audit next week would do irreparable harm.

    A previous audit had concluded the AHF overbilled the county Department of Public Health by $1.7 million in fiscal year 2008-2009, by charging it for costs already covered by Medi-Cal, Medicare, private insurance, grants and fees.

    The new audit would look into whether such overbilling happened in subsequent years as well.

    Weinstein denies the allegation, calling it another form of harassment by the county.

     
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