Balancing Equity and Accountability: Millions in Health Outreach Contracts Draws Questions, Whistleblower Complaint – Voice of OC

As the pandemic lays bare the health disparities facing underserved communities, Orange County health executives are celebrating major federal grant money they secured to help rectify those inequities.

The effort – dubbed Equity in OC – is aimed at reducing health disparities among Asian-Pacific Islanders, Blacks, Latinos, people with disabilities, LGBTQ people and seniors.

County Health Care Agency executives are looking to diversify service delivery, working with smaller community groups to address things like food insecurity, the digital divide, safety, access to green space and participation in society.

But there are more and more questions about the way the proposed contracts are set up, and whether it’s putting taxpayers at risk by flouting safeguards meant to protect against cronyism and corruption.

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The way health officials are handling the contracts has already triggered an anonymous whistleblower complaint to county attorneys from a Health Care Agency employee.

Nearly $23 million in no-bid contracts, funded by a CDC grant to the county, are up for approval Tuesday by county supervisors.

The largest proposed contract would provide $15 million for a nonprofit collaborative called the Multi-Ethnic Collaborative of Community Agencies (MECCA), which would itself provide sub grants to smaller, yet-to-be-named nonprofits. 

The yet-to-be named part of the process, along with weak benchmarking, is triggering questions and concerns.

County officials seeking authorization from county supervisors say those details will be worked out after the contract is finalized. That’s when guidelines for granting the money to the subcontractors would be developed, according to HCA executive Hieu Nguyen.

“Guidelines for grants will be established once [the] vendor is approved,” wrote Nguyen, who heads the agency’s Office of Population Health and Equity, in a written response to Voice of OC’s questions through a spokesman.

There will be strict supervision of the contract by the health agency, said Nguyen.

“HCA will have direct oversight with [the] vendor,” he added.

Yet the HCA whistleblower complaint reviewed by the Voice of OC highlights the fact that the proposed contract doesn’t make clear what the actual work product expectations are for the groups that will end up getting the federal funds. 

Indeed, HCA officials do describe their goals for the $23 million largely in broad strokes – using general terms like  “increased alignment among organizations,” “strengthened community partnerships,” and “improvements to infrastructure to address COVID-19 health disparities/inequities.”

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Organizers have acknowledged they have faced struggles in explaining their plan of action.

In a conference call Tuesday with local health leaders about equity efforts, Nguyen acknowledged feedback from community groups that HCA officials are good at talking about challenges, but not action.

Supervisor Katrina Foley says she’s been pressing for more detail about the plans.

“They did an application to the granting authority. It’s very detailed and specific. And then the [staff report to county supervisors] is slightly different than that,” she said in an interview.

Foley said she wants the $23 million to focus on more immediate COVID-19 priorities in underserved communities, like testing and vaccination.

“My concern is that we ensure that we are prioritizing immediate impact on COVID recovery, intervention and prevention. Because that’s what the money is for.”

The other four supervisors didn’t return messages for comment.

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Among other things highlighted in the complaint reviewed by Voice of OC is the allegation that senior Health Care Agency executives submitted false statements to justify steering contracts without competitive bidding – by claiming no other vendors can provide the services, despite not asking other groups if they can do the work.

In response, Nguyen says time was of the essence to get vendors selected in time for them to complete the work within the grant deadlines, which are September 2023. 

“This is a time-limited grant. Vendors were selected for their expertise, turn-key readiness, and ability to scale up in a timely manner,” wrote Nguyen.

The grant application was approved by county supervisors back in April. A few months later, the CDC signed off on the plan in June. The contracts to implement the plan are now coming back to supervisors this coming Tuesday for their consideration.

The Health Care Agency’s director, Dr. Clayton Chau, didn’t return phone, email and text messages for comment for this article.

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The questions have created a tense delay for the $23 million in implementation of the CDC grant.

In the last few weeks, Chau has twice delayed the item – before deleting it, and resurrecting it.

When Chau first brought the contracts for supervisors’ approval in September, one vendor slated to get $600,000 of the federal funds, Advance OC, was not registered to operate as a nonprofit with the state, while another’s nonprofit status was listed as being in “forfeited” status by state tax authorities.

Chau did not mention that he serves on Advance OC’s advisory board.

Nick Gerda covers county government for Voice of OC. You can contact him at ngerda@voiceofoc.org.

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