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MORE KENO AT KINO: Members of the Pima County Board of Supervisors, as the election year opens in a mere three weeks, gotta be wondering how much more the public can take with the county's horrendously managed health care system and the foundering Kino Community Hospital. Here's a sample of a couple of days worth of headlines in the dailies: "Auditors find Kino woefully managed" · "Kino physician admits to taking drug kickbacks" · "Kino doctor faces action in drug scam."

The doctor, internist Charlie Blanck, happens to be the primary-care doc for Supervisor Raul Grijalva, the third-term Democrat cannonized by The Arizona Daily Star this year as the patron saint of county indigent health care. The state Board of Medical Examiners voted last week to recommend that the Drug Enforcement Agency strip Blanck of his ability to write prescriptions for narcotics. Left out of the stories in the dailies is what Blanck's former boss at Kino, Dr. Richard Carmona, did at BOMEX, which he was appointed to last year. Carmona recused.

And so health system big shots were back in front of supervisors Monday asking for another $1.3 million to try to buy some ability to only start to reverse the downward spiral that has plunged Kino $40 million in debt. Los Angeles-based consultants from PricewaterhouseCoopers reconfirmed what had been confirmed and reconfirmed by Peat Marwick earlier this decade, Arthur Andersen last year and county officials several times: Kino is bereft of any type of management or financial control and hospital officials simply don't bill payers, including state and federal health plans.

Grijalva had a tough day Monday. His motions to do whatever was proposed by the Kino chief exec Honey "Baked" Pivirotto and county Health Commission Chairwoman Sylvia Campoy fell flat. Four died for a lack of a second, including the upfront $1.3 million bailout, one to put dietician Karen Fields, the health system's improbable interim CEO on par with County Administrator Chuck Huckelberry, one to invoke the cancellation clauses on the contracts of all Kino doctors (that's the thanks you get, Dr. Blanck), and a real sneaky attempt to win backdoor board approval of the wild 60 percent raise -- to $148,409 a year -- the commission engineered for Fields last summer.

Democrat Dan Eckstrom salvaged an improvement plan, winning approval for a motion to allow Kino $1.3 million in additional spending authority. That is sharply different from the gift Grijalva wanted to make because Honey and her Kino crew will have to produce some results -- as in sharply increased receivables -- by the time the fiscal year ends June 30. Meanwhile, RFPs will go out for physician services to seek lower costs.

In all the fancy consultant-speak (PricewaterhouseCoopers was paid $210,000 to produce its findings in a 71-page report that was decorated with photos of Monument Valley), there were some basic, chilling admissions. Personnel safeguards (i.e., timecard practices) were being put in place to make sure employees are truly employees. The staff has failed to screen patients to get eligible sick into one of the indigent care health plans so that Kino will be paid. Pivirotto also claimed that for months, including since the time she was installed into her $113,400-a-year job in September, Kino didn't collect fees for orthopedic services, even though most of the patients were eligible for one of the state's indigent health care plans. That's just one of the things that makes us wonder what Honey does during her 18-hour days at Kino.

The real key to saving Kino and the other components of the county's health system remains de-commissioning the Health Commission.


HOT SEAT: Amphi Board member Ken Smith was in court this week, fighting to keep his seat after Pima County Attorney "Santa" Barbara LaWall filed a special action last week to knock him off the Amphi School Board, alleging that it's illegal for Smith to serve on the board because his wife, Barbara Smith, is in an early retirement program that requires her to work 20 days a year for the district.

Since his landslide election in November 1998, in which he crushed former Amphi Board President Mike Bernal, Smith has joined colleague Nancy Young Wright in bringing remarkable reforms to the Amphi district. Naturally, he's being repaid with a legal challenge to his right to hold the seat.

LaWall's sticking to her story that she had to file the action against Smith -- which simply isn't true, says Smith's attorney, Bill Risner, who notes, "Whether she brings a quo warranto (action) is a discretionary matter."

LaWall's vigilance in this case is extraordinary, given the various scandals she's ignored at Amphi in the past. Maybe she'll look into the district's misuse of the state's emergency procurement code when it scraped-and-raped the controversial new high-school site after a federal appeals court lifted an injunction preventing construction last week.

The Amphi administration, which opened this can of worms when Amphi staff attorney Todd Jaeger reported Barbara Smith's retired status to outgoing County Schools Superintendent Anita Lohr, may find itself further embarrassed by its clumsy and transparent political maneuvers. According to Risner, Amphi has claimed in the past that early retirees are not compensated for their work in the classroom.

"I got one letter from a person who's retired where (Amphi administrators) say that as an early retiree, the monies he received are no way connected with any current service and that the total sum received by him is based on his prior service to the district," says Risner.

Risner's efforts to learn more about Amphi's past positions have been stymied by the fact that the stonewalling district has yet to respond to his request for public records.

On Tuesday, Superior Court Judge Kenneth Lee granted Risner time for actual discovery, to pry key documents from Amphi's vaults, before resuming court proceedings around the second week in February.

Smith retains his seat but will not vote on any matters. He and Wright have been on the bottom end of many 3-2 votes, but have nonetheless shocked the conscience of the district taxpayers and parents, if not the administration.

Jaeger sat smug in court, with costly representation by his side. John Richardson, of DeConcini McDonald Yetwin & Lacy, is dipping into yet another public trough to go with all he grabs from TUSD and Sunnyside.


KING GEORGE ABDICATES: All hail -- Tucson Unified School District Superintendent George F. Garcia announced over and over again that he will do the right thing and resign in June. This marks the end for King George and Queen Mary, the peroxide wife whose resignation from the head job at Sunnyside Unified School District also is effective at the end of the school and fiscal year.

Garcia lasted nine years here and could easily have lasted another. Only one Board member, Rosalie Lopez, had the guts to question his performance. She was going to call for his resignation if he didn't submit one. Three members, Mary Belle McCorkle ("ooh, let's have another expensive retreat") Joel Ireland and James Christ were pure Garcia sycophants. That majority is set to actually give Garcia a pay raise in January. In the incest that is Tucson school systems, Christ has to treat Garcia with kid gloves because Mary Garcia is Christ's boss at Sunnyside. The party, thankfully, is over.

True to his commanding public relations force, Garcia is going out with nothing but puff. His resignation letter is a windy, self-congratulatory three pages, much of it packaged (in advance) as an op-ed piece in The Arizona Daily Star on Sunday. Garcia's buddy, Jim Kiser, is the editor of the Star's editorial pages and his wife, Shirley Kiser, runs Garcia's over-hyped, little-producing 4th R program.

Garcia was effective at one thing, as noted by disparate voices -- Lopez at the end of his tenure and Sylvia Campoy, a one-term Board member, at the beginning: polishing his own image. He was tireless at meeting and schmoozing business and social leaders in Tucson. But it only was for himself. It did nothing for the students, parents or teachers. Nothing.


TORTIOUS TORTURE: An editing change in last week's story about Pima County consultant Bruce Postil left an incorrect description of a lawsuit Postil, a former deputy county manager, and six other demoted or fired county employees successfully filed in 1993. Even we doubt that former Supervisor Big Ed Moore tortured anyone. Among the lawsuit's claims, however, was tortious interference.

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