County Connivers

Maricopa County Administrator David Smith was named best county leader in the nation by Governing Magazine in November 2001.

Now Smith deserves to lose his job.

The publication, which is read by practically every high-level bureaucrat in the nation, had gushed that Smith performed miracles in leading Maricopa County out of a $65 million deficit he inherited when he took over as the county's top gun in 1994.

The glossy magazine stated that a key part of Smith's success was the amazing financial rebound he engineered at the Maricopa Medical Center, which had been a financial black hole for years costing the county untold millions of dollars.

In its glorification of Smith, the magazine stated that the county hospital turned an $18 million profit in 2001.

Smith, who is virtually invisible to the public and rarely submits to interviews, revealed his management secret to Governing Magazine:

"The first thing we had to do was impress on people the importance of fiscal responsibility and budget integrity."

What a guy!

What a bunch of bull!

County records I dug up reveal this: At the same time Smith was getting hailed for his financial wizardry, he knew that the county hospital was facing Armageddon -- that its books were chock-full of errors.

At the time, a private firm, Quorum, was managing the Maricopa Integrated Health System that includes the county hospital, 13 clinics and four health-insurance plans.

Rather than the hospital being flush with profits, Smith knew it was actually losing tens of millions of dollars a year, forcing the county to transfer cash from the general fund to keep its doors open.

Not only was Smith facing steady ongoing losses at the hospital, a new crisis was fast approaching.

Figures in Quorum's financial reports were not matching records kept by the county treasurer. County auditors discovered in March 2002 that Quorum overstated the health system's cash flow by $100 million over the previous four years.

Whoops! This meant the county would have to pour in even more money from its general fund to prop up the health system.

Then, yet another major problem cropped up.

A new computer system purchased for $4.2 million in October 2002 was fouling up hundreds of thousands of bills. The county struggled with the system, could never get it fixed and finally decided last month to abandon it.

Rather than come clean in 2002 that there was a major financial crisis in the making, Smith and the Maricopa County Board of Supervisors kept the public in the dark.

Only now is the extent of the damage becoming apparent.

Earlier this month, the county announced that the accounting and software mess together will cost taxpayers an estimated $82 million to $129 million.

This is in addition to the massive ongoing operating losses suffered by the hospital that have averaged $35 million annually over the last five years.

Smith and the county supervisors had a prevailing reason for keeping the health system's financial meltdown secret. The county desperately wanted to unload the ailing Maricopa Integrated Health System on the countywide health district that the Legislature created in July 2003, pending voter approval.

In November, voters endorsed the health district without knowing that it was in such a serious financial bind. Further, the new district isn't allowed by law to raise anywhere near the money needed to shore up the massive health system.

Thanks to David Smith and the county supervisors, the health-care safety net for hundreds of thousands of poor and uninsured county residents is seriously threatened. The county's health system receives more than 300,000 outpatient visits a year, 80,000 emergency room visits and admits another 20,000 patients into the county hospital.

But it's not only the unwashed masses who risk losing access to a hospital that won't turn them away because they don't have insurance. The well-off, too, are jeopardized. Maricopa Medical Center has the best burn unit in the Southwest, is a topflight trauma center and has a first-rate neonatal unit.

The screw-ups that led to the $82 million to $129 million accounting and software black hole are of such a magnitude that it appears they could have been done on purpose.

"The sense I get from people who are close to what is going on is that there was some criminal activity," a state health-care regulator tells me. "A forensic audit will uncover [what happened] pretty easily."

It's obvious that we can't rely on the county supervisors to bust open this scandal.

State and, if necessary, federal authorities must dispatch a team of bloodhound accountants to determine whether this gargantuan loss of taxpayer money occurred because of a huge mistake -- or whether the funds were pilfered.

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John Dougherty
Contact: John Dougherty