Technical assistance

Conflicts as OC’s chief health officer recommends $ 600,000 no-tender contract with supplier he advises


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Orange County health director raises conflict of interest questions as he recommends hiring a contractor he advises next door for more than half a million dollars worth of work in the county – all without a call for tenders.

Dr. Clayton Chau also does not disclose his position on the advisory board with contractor Advance OC in his recommendation that the county hire the supplier for $ 600,000 in non-tender work, for approval on Tuesday.

Chau should, at a minimum, be transparent about her relationship with the contractor – Advance OC – if not entirely recuse herself from recommending them for work in the county, said Tracy Westen, a government ethics expert who previously headed the Center for Governmental. Studies.

“I would definitely recuse myself. It’s a clear conflict of interest, ”Westen said.

“This is definitely something that should be disclosed,” he added.

Chau declined to answer questions for this article, telling a reporter last week that he was in a meeting and deferring his comments to a spokesperson for the Health Care Agency.

A statement provided days later by the spokesperson said that Chau and the other members of the advisory board were not making decisions at Advance OC, but rather providing “technical assistance” to the supplier.

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Advance OC relies on Chau and his other advisory board members for their expertise on new features of Entrepreneur Services, which focus on creating online health data maps that highlight underserved communities. .

“Its particular role is to give us an idea, from a public health perspective, of how different functionalities would be intertwined in our platform,” said Katie Kalvoda, Founder and CEO of Advance OC, in a statement. interview.

“We come to them when we have questions about different things, and we rely on them for their experience and expertise,” she said, adding that members of the advisory board have no voting rights on the way Advance OC is managed.

But Chau’s advisory position to the contractor should cause him to steer clear of any involvement in his recommendations as a county official for them to get contracts.

The lack of a call for tenders for the $ 600,000 contract, he added, “does not help matters.”

“The public has a right to know that their officials are making the best decisions possible, without personal bias,” Westen said.

“They deserve to know that they are getting the best government possible,” he said.

This is not the first time that Chau has faced conflict of interest issues.

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He was fined by state authorities in 2014 for failing to disclose the lucrative speaking expenses of a pharmaceutical company while working as a senior psychiatrist at the health care agency of the county he now heads.

He was awarded $ 84,250 in apparent violation of an agency policy against accepting such payments, according to a 2013 Voice of OC investigation that revealed the payments.

As to why there was no tender for Advance OC’s initial contract last year and the next one proposed, Chau’s office said the first contract came in because they “were looking for quick fixes to understand community needs related to COVID testing and other related COVID responses. “

The proposed new contract of $ 600,000 – funded by a federal grant from the CDC – would build on this work, Chau’s office said, adding “that there is not enough time to work with a new supplier. “.

The new conflict concerns arise amid reports that Supervisors Chairman Andrew Do is trying to transfer Chau to CalOptima, the county’s multibillion-dollar public health insurance for low-income, disabled and disabled residents. aged.

Do and Chau did not return messages asking if there is any truth to these reports.

Advance OC was less than a year old when it secured its first non-competitive county contract in July 2020, to develop an online map showing the disparities in health and quality of life in County of Orange.

The recommendation to hire Advance OC for this work was not made by the health agency but by a politician – Do – who in turn publicly credited Chau for leading the effort and involving Do.

“I completely bought into it. So I want to thank Dr. Chau for taking the lead on this,” Do said just before voting for Advance OC’s initial $ 385,000 contract.

In its report justifying the first contract (LINK), Do said this would allow the county to map social equity data – not noting that the county was already paying for a separate ongoing social equity data initiative, known as the name of Orange County is healthier overall.

The new $ 600,000 contract offered for approval on Tuesday is recommended by Chau without a tender to see if Advance OC is the best supplier for the job.

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The Advance OC contracts have prompted questions about why the county is paying Advance OC $ 102,000 to complain about HIPAA privacy law – when standard county practice would be to expect. that its contractors are already HIPAA compliant without additional payment.

The CEO of Advance OC said the county expects them to have enhanced security beyond the usual HIPAA requirements.

“The HIPAA compliance that is required of us is much more detailed because we are dealing with sensitive information. And that was to meet these more intensive demands, ”Kalvoda said.

When asked if they handle individually identifiable information, Kalvoda replied no, but that the data will be presented on “a community platform, so we need to make sure we have security measures in place. high confidence… because it is a public good. “

Chau’s office said the original contract was based on public data that did not require HIPAA-level security.

But that security later became necessary “when we determined that we needed to see COVID cases and deaths across the county in conjunction with Social Progress Index data in order to develop targeted COVID responses,” he said. Chau’s office wrote in the statement.

The statement was attributed to Hieu Nguyen, director of the Bureau of Population Health and Equity, and Karin Kalk, director of the Bureau of Project Management and Quality Improvement.

Questions have also emerged as to whether the county’s hiring of Advance OC duplicated much of the work that taxpayers were already paying $ 66,000 a year under the Healthier Together initiative, which largely contains part of the same information as the Advance OC card.

Chau’s office said the Advance OC map – known as the OC Equity Map – provides more detail and functionality.

“The design, content and interactive capability of the OC Equity Map allow users to see layers of data and better understand the complexity of issues a given community may face,” the statement said.

“Additionally, the OC equity map can be overlaid on other data elements, including COVID-19 data and health outcomes, to show the relationship between social progress and health outcomes. within a community / neighborhood. “

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Kalvoda said the Healthier Together initiative was actually inspired by Advance OC’s mapping effort.

“The two cards they show on their website… took over from us,” Kalvoda said.

“After seeing what we did and they clearly felt left behind in the equity mapping trend, they attempted to do something very similar on the surface,” but not as detailed, she added.

As for the lack of a tender, Kalvoda said the CDC grant that funds the effort allows the county to expand its existing partnerships.

“I can’t speak to the county’s approach in this regard, but I think the CDC grant they’ve been given allows them to make decisions about having particular partners who have already contributed to the process. or have something specific to offer, ”she said. noted.

Concerns are growing over unrest within the County Health Care Agency, including unprecedented leadership turnover during the pandemic – with the three top officials and several other executives suddenly leaving.

Earlier this month, Voice of OC reported that one of Chau’s top assistants, Margaret Bredehoft, had been investigated this summer as part of an internal investigation, with officials refusing until now to say what the investigation revealed.

The confirmation came in response to a request for recordings from Voice of OC for any substantiated allegations against Bredehoft regarding discriminatory hiring practices, retaliation and a hostile workplace.

Bredehoft declined to comment when contacted by phone earlier this month.

Nick Gerda covers county government for Voice of OC. You can contact him at [email protected]

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