Allegations Regarding Certain Activities of the Health Systems Agency for Los Angeles County, California

Allegations were made regarding the following activities of the Health Systems Agency for Los Angeles County, California: (1) election of members to subarea governing bodies; (2) outside legal counsel; (3) hiring of the Executive Director and staff; (4) deviations from the budget; and (5) the Department of Health, Education, and Welfare's (HEW) monitoring of the agency. The agency did deviate from several election policies and procedures in its bylaws. While the agency made a reasonable effort to inform the public, Los Angeles County residents were generally not aware of the elections. The registration process made it difficult to participate in the election, and the agency did change, on several occasions, the consumer or provider classification of various candidates. No conclusions were reached on the reasonableness of expenditures for legal services since the hours billed could not be independently verified. The agency hired numerous individuals not meeting minimum qualifications, and procedures used in hiring employees were not documented in many cases. Several employees did not perform the duties of the positions for which they were hired. A major revision to the agency's budget was approved by HEW on the basis of incorrect and misleading information. Revisions to the budget were not always approved by the agency's interim governing body, and agency funds were often expended for revised budget items before HEW approval of the changes. HEW was not adequately monitoring the agency, and violations of federal regulations were identified in the case of a former HEW employee currently employed by the agency.