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“Hello, Max. This is Jane Holmes, Los Angeles County. I need your help.”
Wow! This is unprecedented. Jane personally calling me, not a member of her staff placing the call first. This meant something was seriously wrong. Incredulous, but without hesitation, I responded, “Good morning, Jane. What can I do for you?”
“The county is implementing fifteen new systems in all six of our hospitals, and something is out of control. Catherine and I do not know what it is, so we need your help.”
Jane was the CEO of LA County. One of her associate CEOs, Catherine Yen, a brilliant and feisty fireball, controlled the county Department of Health Services’ (DHS) $4 billion budget. Jane asked, “How fast can you come down here?”
With my office in Seattle and my home on a nearby island, I made travel arrangements to meet Jane. I did not wish to sound like I was anxiously awaiting client work. But I wanted Jane to know that I was ready to address her urgent situation as quickly as possible. I had a long history of working with LA County, and I knew the airline schedule without looking it up.
“I’ll be at your office tomorrow at 1:00 p.m. What can I do to prepare for our meeting?”
“Catherine’s senior associate, Dave Locke, will send you his research.” Adrenaline raced through my veins. I thanked Jane. I must admit I hoped the enormity of the challenge, the complexity of the work, and the resulting fees would allow us to finally open an LA Office. We really needed a physical presence to better serve the county, our largest client, and a massive market.
When I arrived at Jane’s office the following afternoon, Grace Worth, her senior administrative assistant, recognized me with a smile and politely asked me to wait a moment. Grace checked with Jane and ushered me into the boardroom adjoining Jane’s Office.
Jane looked different. I hardly recognized her. She read my reaction and laughed in her usual infectious manner. She said, in her all-knowing tone, “I lost forty pounds!”
She reached forward, embracing me as a friend. I noticed no cigarette odor. She must have quit in addition to the weight loss. She honored me with her heartfelt greeting as we asked with genuine interest about our kids and spouses since seeing each other a year ago.
When we sat, Jane explained the county signed a contract with Global Management Information Systems (GMIS) to implement financial, administrative, and clinical applications. The county started implementing the financial software before continuing with the electronic health record (EHR) and administrative applications like scheduling, radiology management, patient tracking, and so on. The project included all county hospitals and outpatient clinics, the nation’s second largest public health system.
Politics reign supreme in LA County, and this project was no exception. In fact, it sounded worse than I expected as Jane explained.
“The $145 million project financing is in municipal bonds. The county uses the funds from these bonds to issue payments to GMIS at project success milestones. Both the uninformed and malicious may assume the county will default on the municipal bonds if the project fails. While this is wrong, any ensuing public belief like this could affect the county’s creditworthiness and lower its bond rating. The lower the bond rating, the higher the future borrowing cost to the county. This could cost the county millions of dollars.”
My stomach twisted, and I feared Jane would read this internal reaction on my face. It was always hard to hide anything from Jane, given her decades of political experience and Ph.D.s in economics and psychology.
Then Jane delivered more unwelcome news. Did the county CIO, Clarence Willoughby, commit illegal acts accepting GMIS’s box tickets to a Dodgers game during the procurement process? Are there other suspicious activities with the vendor? To me, Clarence was slippery. I never understood why Jane supported the board of supervisors (BOS) in hiring him. He was a bully at best and a crook at worst.
She ended her project description by saying I must tell her at once of any adverse issues involving Clarence so she could notify the district attorney (DA). These issues were the responsibility of DA investigators and not me.
I felt relieved. I am Max McLellan, an IT project manager (PM), not Sherlock Holmes, a detective. I gladly accepted referring any potential criminal activity to the DA.
Jane also noted I reported to her under county counsel attorney-privileged communication. Should a court case ensue due to this endeavor, I could claim everything I did was privileged. Jane explained this was a technicality. I would not report to county counsel under any circumstances. She suspected county counsel contributed to the current crisis. I reported to Jane only, at the board’s direction.
I was always cautious on troubled projects. The findings in our work could end careers, or at least cause unwanted job changes. This was never something I relished. I made it clear our role was always to find the problem and deliver a solution while considering the impact on all of those involved. We were talking about people’s lives and their income, families, and future. We never took this lightly. We confirmed our findings with at least two independent parties and documented our communication with the utmost care. We had a long history of client success on these kinds of projects. I certainly intended to keep it that way for this project, too.
INVESTIGATION
Jane sent me to meet with Catherine and Dave with an agreed-upon budget and an impossible 30-day schedule to conclude my investigation. I told Jane the schedule was not realistic. She acknowledged my response with, “We must live with this board directive, at least for now.” That was hardly satisfactory, but I did not push it. She said at least, which gave me hope for future negotiations. However, the board was an intractable entity in most cases and always in a crisis. They wanted me to end this disaster so they could forget it as quickly as possible. BOS members used their current position as a stepping-stone to state and national Offices. For example, Sylvia Tacsan, the current BOS member responsible for health care, had the highest-ranking elected position of any Latino female in the country. The outcome of this project could derail the political future of very influential people.
When I met Catherine, she smirked and said, “County Health was at it again. They could not do IT right. The only way DHS knew the scope, time, and cost of their projects was after they completed them. Most times DHS stopped just short of that with huge financial and time expenditures and not much else. So, in this situation, we’re ahead of the game.”
I laughed. Catherine was both tough and hilarious at the same time. She introduced me to Dave, sending us to his Office to follow up on the information he sent me for our meeting.
Dave was a gray-haired, no-nonsense senior advisor, who clearly knew how to minimize press involvement and the ensuing political nightmares that could occur at any moment. I embraced everything he offered, trusting his guidance implicitly.
He made it absolutely clear I must meet all players, including GMIS’s PM and team members, DHS director, county counsel, hospital representatives, DHS and county CIOs, and others. He underscored they must honor my requests for an interview and for documentation, as I worked directly for Jane and the board.
Dave concluded our meeting, emphasizing I should start by assessing Oscar Berke. DHS recently designated Berke to direct this investigation, support my research, and execute my recommendations. Oscar was chief financial Officer (CFO) of Rancho Los Amigos National Rehabilitation Center (RLANRC), one of the county’s six hospitals already implementing the troubled GMIS system. Oscar expected to fill DHS’s CFO position in the coming months. This was the pinnacle financial career position in DHS. The DHS CFO spent their time with the county CEO, BOS, governor, and Health and Human Services Cabinet secretary and president negotiating county health care funding. Oscar had a reputation as the person responsible for solving DHS’s problems by getting things done with minimal political consequences, especially when there was a crisis.
It was warm, but the walk from Dave’s office at the Hall of Administration to DHS was only short blocks downhill. While everyone drives a car in LA, I enjoyed staying at a hotel walking distance to the multiple block acreage of county Offices.
DHS’s headquarters was a nondescript dirty white Office building longing for a change, like the organization within it. Despite the warm weather, twenty-somethings in hoodies clustered outside the front steps smoking cigarettes. I stayed clear, quickly skipping steps, as I climbed the stairs and entered the main lobby. There was a guard sitting behind a cheap metal desk, thrown in the middle of the elevator lobby to show a false security perimeter. The guard quickly stashed a porn magazine in the desk drawer and looked at me officiously. He gestured toward the clipboard, and I signed in while averting eye contact to avoid embarrassing him further.
DHS’s elevators were in competition with all government buildings to see which were the slowest. Once an elevator arrived, dispirited employees slowly disembarked. It was a shabby world, apart from the bright sunny day outside. There was no reason to hurry as the elevator doors closed leisurely.
The smell of janitorial disinfectant greeted me as the elevator doors opened on the fifth floor. I stepped out into a narrow, bland hall with numbered Office doors. I went sequentially to Oscar’s Office door. Should I knock or just enter? I decided to knock. Nothing happened. I waited a moment and then turned the knob and crossed the threshold.
Bright lights and a hum of activity enveloped me as I entered a crowded central room with multiple Offices around its perimeter. It was like stepping into an alternate universe.
A short woman burst around a partition to greet me. She was fleshy and round, with a bowl haircut and a big smile. Amanda Smithers introduced herself as Oscar’s assistant. She was expecting me and apologized for not answering the knock on the door. She explained she was just ending a call, which prevented her from greeting me properly.
Amanda showed me into Oscar’s Office. The first thing I noticed as I went in was his Office door. Every conceivable inch included randomly posted layers of newspaper and magazine cartoons.
In contrast, Oscar was meticulous, with precisely organized papers on his desk and books on his metal shelf by a small window. He wore a perfectly pressed light purple shirt, matching tie, and dark purple suit and shoes. It was oddly subdued, and on him, it worked. This complemented his dark Mediterranean complexion. He had the tight and strong build of a long-distance runner. His most outstanding feature was his jet-black hair, swept back with a shock of silver on the right side of his forehead. He had a strong, warm, and confident presence.
Oscar shook my hand firmly, looking me straight on with a pleasant smile. He started at once, saying, “I know how to use IT, but not how to manage it.” He then asked me how we should go ahead. I suggested he start telling me everything he knew to date about the project, including the organizations, names, roles, and responsibilities of the players.
Oscar was hard to read. He pleasantly reported facts, but with little verbal or nonverbal elaboration. He gave nothing away, clearly politically savvy. To great personal relief, I soon learned he used this political skill to advance the best interests of the public, not necessarily that of DHS or county government entities.
Oscar was intelligent and capable. Whether he was the right person for the project fix remained unknown. I needed to find the right person soon. I wanted success from someone in the department’s ranks, like Oscar, not the result of an outsider. DHS would never recover fully unless it fixed this mess on its own.
Following Oscar’s introduction, I read documentation he supplied and then started my interviews. During the following two weeks, I crammed in four to five two-hour group interviews each day. These were mostly in small teams responsible for key areas, requirements management, GMIS application analysis and development, project leadership, and so on. I also completed one-on-one interviews with the likes of the DHS director, hospital CEOs, hospital, department, and county CIOs, county counsel, and GMIS PM. Taking notes on my computer throughout each interview, I highlighted and summarized my findings before starting the next one. It was exhausting, but the BOS’s 30-day schedule demanded it.
My DHS director interview was most telling. Jack Dice, Ph.D., was a distinguished, tall, muscular, and professorial man. He had a baritone voice and inquisitive blue eyes, focusing unwaveringly on whomever he met. I sat in his large Office overlooking downtown LA. The Dorothy Chandler Pavilion, w...
