AN OPEN LETTER TO THE BOARD OF DIRECTORS

OF GOLDEN VALLEY HEALTH CENTERS

December 2, 2014

Subject: Hostile Work Environment; Wrongful Termination; Harassment;

Retaliation; Code of Conduct; Discrimination; Conflict of Interest; Quality of Patient

Care; and Violations of State and Federal Laws.

Dear Board of Directors,

I am writing on behalf of myself, the public, and the patients, medical staff and

providers of Golden Valley Health Centers (GVHC) to respectfully request that the Board of

Directors of GVHC begin an investigation on the complaints that the Board has received,

including the issues and complaints outlined herein. To my knowledge, recent complaints

contain allegations relating to: (1) creation of hostile work environment; (2) wrongful

termination, harassment and retaliation of a number of medical providers and

employees; (3) false imprisonment of the Chief Medical Officer (CMO); (4) violation

of the Golden Valley Health Center code of conduct; (5) discrimination; (6) gross

conflict of interest and nepotism; and (7) violations of one or more states and

federal statues, including federal statutes governing Federally Qualified Health

Centers (FQHC).

[REDACTED]

(1) Hostile Work Environment

Anyone working at Golden Valley Health Centers (GVHC) today will tell you there

are two opposing factions since Mr. Tony Weber’s appointment as CEO of GVHC. Mr.

Weber has successfully created a hostile work environment and a culture of

oppression, a ‘we against them’ disposition that not only endangers the well-being and

security of the medical staff and providers but also the care quality for patients of GVHC.

Mr. Weber has stated specifically to Employee#1, former Chief Medical Officer of GVHC,

that the GVHC Mission was not enough to retain her, that he required 100% support from

Employee#1. A few days after their discussion on patient care quality, Employee#1 was

CRITICAL: PLEASE CAREFULLY REVIEW

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wrongfully terminated (for among others, expressing concerns regarding quality of care,

conditions of care and provider work environment (MD, DO, NP, PA, LCSW at GVHC). There

is a prevailing sense of fear; there is no freedom to express oneself, without fear of

retaliation from the leadership team, including the CEO, COO and Chief of Human Resource.

On November 21, 2014, Mr. Weber invited all GVHC providers to a meeting with

himself and some members of the Board. The objective of the meeting was to pacify the

GVHC staff and quell the burgeoning desire for justice and action from the Board. Instead of

alleviating fears against retaliation and uplifting spirits, Mr. Weber solidified his image as

dictator and oppressor by talking down on the medical staff, including doctors, in a

disrespectful and very unprofessional manner. Such conduct is unbecoming of a CEO

and violates GVHC code of conduct (and a key Core Value – Respect). Even

Employee#10(Attendee#1), a psychiatrist in practice for over thirty years and former CMO

at GVHC, commented on (1) how Mr. Weber intimidated providers and doctors; (2) how

Mr. Weber talked to respected medical providers in a condescending tone; and (3) that the

way Mr. Weber talked to the staff does not engender a peaceful resolution.

For example, following are excerpts from the November 21 meeting:

Attendee#1: So, the first question, “Can we voice our opinions without fear of retaliation,

several persons have been fired?”

Mr. Weber: Not a fact. I only know of several persons were fired. Like I said, I have no

hit list.

…..

Attendee#2: Can you tell us that truth?

Mr. Weber: You want me to read it for you?

Attendee#2: Oh, absolutely, please. A lot of us know who Employee#2 and Employee#1

are, and you kind of tell us how bad we are, as people, how shitty employees we are.

Mr. Weber: Now do you want to respect me or you don’t want to respect me?

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Attendee#2: Well you don’t respect anybody here. (I’ve been respecting everybody here.)

My god, you are treating us like bad children.

Mr. Weber: I’m treating you like bad children?

Attendee#1: Okay, let’s try again, let’s start over.

Mr. Weber: This is what I’m talking about, we’re not going to do this. Okay?

Attendee#1: Excuse me here, but I have to say that the way you are talking to us with all

due respect, doesn’t engender peaceful resolution. You are in command, that you are

speaking us is very intimidating.

Attendee#3: You are condescending, sir.

Attendee#1: We must either join you or chose to leave.

Attendee#3: If we don’t join you one hundred per cent, we get fired too?

Attendee#1: This organization has worked very hard, have the mission in mind, and you

come in 5 months ago and you believe that yours and the boards mission is much

stronger, or somehow much strong or ours is not as strong and I am willing to resign at

the end of this meeting. (clapping). What I’m hearing does not engender any trust, and

that’s going on, and I am sorry, and I think I am speaking for many people…

Attendee#3: you are very rude and condescending.

Attendee#1: There has been many, I am not saying that, there’s something wrong with

this picture, and I respect Price, I’ve worked with him as CMO, but maybe it’s a lack of

communication, where is the board moving? What is going on? We are in fear, many of

us are, thankfully I’m not, I work one day a week, I’m contracted and I can leave, but

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many are in fear who is going to go because there’s no rhyme or reason that they can

see.

As can be seen from the above examples, Mr. Weber had a chance to unite the GVHC

staff; instead, Mr. Weber further divided the staff, and accelerated the number of providers

and doctors who have resigned and are contemplating employment elsewhere after the

meeting on November 21. The psychological well-being of GVHC providers and employees

were severely affected by Mr. Weber’s repeated pervasive and offensive words and actions.

Almost all providers fear retaliation from Mr. Weber and his lieutenants, some taking

medical leave to escape the hostile environment constructed by Mr. Weber. While a hostile

work environment does not create a legal cause of action per se, it (1) violates GVHC code

of conduct; and (2) will lead to discrimination and other legal liabilities. More importantly,

a hostile work environment will damage the GVHC brand and image and crush staff morale,

indirectly leading to lower quality of care for patients.

The Board must move quickly to enjoin Mr. Weber from further actions and

expressions that would otherwise create a hostile environment and invite litigation and

subject GVHC to further liabilities.

(2) Wrongful Termination and Harassment of Providers and Employees

Since Mr. Weber’s appointment as CEO in May of 2014, Mr. Weber has manifested

what appears to be a sinister agenda directed towards leaders of executive and clinical

position who have questioned his credibility prior to his appointment as CEO. The Board

has a fiduciary duty to investigate the very likely possibility of a personal grudge and

harassment that led to the wrongful termination of (1) Employee#2 LCSW, MAC, with

more than 9 years of services to GVHC and was the previous Head of the Behavioral Health

Department and Director of Talent and Culture, (2) Employee#3, Center Manager of West

Modesto Clinic for 14 years, and (3) Employee#1, MD, Chief Medical Officer at GVHC for

over 17 years, who may have also been falsely imprisoned by the leadership team (CEO,

COO and CHR). The wrongful termination of Employee#2, Employee#3, and Employee#1

may be in violation of a number of state and federal labor laws. The false imprisonment of

Employee#1 is a clear violation of GVHC code of conduct and may constitute a felony crime.

In the case of wrongful termination of Employee#1, Mr. Weber praised Employee#1

and offered the following regarding her termination in the November 21 meeting with

providers:

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Mr. Weber: I can tell you that as far as a clinician, I respect Employee#1. She is a terrific

clinician as far as being a support and an influence to you all, absolutely. She’s a

fantastic CMO when it came provider relations, but there is more to being a CMO,

there’s more to being an executive, there’s more to being an executive team member than

to remain competent at your specific job in your field. As a executive team member or

any leadership position at this organization we have an obligation to trust one another

within our teams, to support one another within our teams, support decisions that are

made in our teams and ultimately support the board and the direction that they outline

for us to go and to support the CEO. I worked with Employee#1 for several months and I

have months’ worth of documentation, and if I can share it with you, I would share with

you, but it came down to whether or not Employee#1 and me, Employee#1 and the

executive team can work together and move forward to achieve all the goals, and all the

challenges we have going forward. It was my decision that after months that it wasn’t,

that Employee#1 is not the right person to take the job, is not the right person to take this

organization forward to wherever we need to go, it was a tough decision…

Based on the above, there is no cause for termination of Employee#1 and given her

years of services and the actions taken by Mr. Weber, the Board should investigate whether

Employee#1 (along with Employee#2 and Employee#3) was wrongfully terminated. In the

case of Employee#2, she may have had an oral contract based on her discussions and

interactions with Employee#1, Employee#4, and Employee#5, then Interim CEO, all of

which were still members of the GVHC leadership team and had authority to contract.

More specifically, all three leaders offered (and Employee#2 accepted) an oral agreement

for Employee#2 to train (e.g., specialized training to GVHC providers) and to continue to

provide expert clinical supervision in behavioral health for approximately a period of 3

years. Employee#3, on the other hand, refused to schedule new patients for providers as

directed by Mr. Weber because patient care and quality would have suffered. Subsequently,

Employee#3 was terminated shortly after her refusal to implement Mr. Weber’s directive.

Equally troubling, it is well known among the staff that Mr. Weber forced the

involuntary resignations of a number of employees shortly after his arrival. For example,

Employee#5, previous Deputy CEO and Interim CEO who worked for over 23 years at

GVHC; Employee#6, Director of Nursing who worked for GVHC for over 8 years; and

Employee#7, Grants Manager who worked for GVHC for over 9 years, all suddenly and

involuntarily resigned from GVHC after years of distinguished services. These untimely

departures should also be investigated. In the case of Employee#5, Employee#6, and

Employee#7, all resigned under extreme pressure and weight of a hostile environment, as

evident by Employee#6’s letter to the Board shortly after her resignation. Regardless of

whether or not these employees have legal causes of action against GVHC, Mr. Weber, Mr.

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Mark Millan, and Mr. Michael Buda (all named in Employee#6’s letter) created a hostile

environment and violated a number of GVHC codes of conduct. Therefore, an investigation

by the Board into these departures is warranted.

Further, there is the harassment of Employee#4, LCSW, the current Head of

Behavioral Health, and Employee#8, Center Manager of the Turlock site. In the case of

Employee#4, Mr. Weber, in the presence of Mr. Buda, verbally abused Employee#4 with

profanities1 and cited Employee#4’s refusal to terminate Employee#2 as the basis of his

anger. As for Employee#8, she was questioned by her supervisor (Adam Heath) as to the

level of loyalty she has for Mr. Weber. Disgusted with the question, Employee#8 left the

premises as she felt she was being harassed by Mr. Heath and senior leadership. Clearly, a

pattern of hostility is widely prevalent across all GVHC sites. Such past and current

harassments of employees may violate federal employment laws and California Fair

Employment and Housing Act and its implementing regulations. These serious concerns

of workplace harassment are widely talked about among the medical staff and should be

thoroughly investigated and, if applicable, reported to the Department of Labor and other

investigative bodies.

One of the major issues that may have led to Employee#1’s wrongful termination

was Employee#1’s opposition to Mr. Weber’s incorporation of six NEW patients per day for

every provider. Mr. Weber considers this an effective way to increase access. Regardless of

a provider’s specialty or position, this directive from Mr. Weber will compromise the

health and safety of each and every patient (GVHC has over 100,000 patients).

Furthermore, Mr. Weber’s directive is an unrealistic expectation and demonstrates the lack

of business acumen and leadership necessary to lead GVHC. Clearly, Mr. Weber, having

previously been a Chief Financial Officer, is new to the position of Chief Executive Officer

and lacks the medical background to fully understand the health and safety consequences

of his decisions and directives. It appears that Mr. Weber’s directive is solely based on

financial gains. The “new patients” directive by Mr. Weber is unsympathetic to both

providers and patients and is detached to the humanity involved in a healthcare setting.

Not only does this endanger the health and safety of new patients, who are only given

10 minutes to be seen, it DECREASES access to the over 1,500 patients a single full-time

provider has in his/her panel. GVHC providers are not automatons, and most especially,

our patients are more than just numbers. In short, Employee#1 was wrongfully terminated

for raising concerns regarding health care conditions and patient care and quality. In fact,

Employee#1’s case (and possibly Employee#3’s case as well) is a classic case of retaliation

1 Mr. Weber’s use of profanities is in violation of GVHC code of conduct; therefore, Mr. Weber should be disciplined accordingly.

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and her termination is in violation of a number of California Labor and Health and Safety

codes.

Regarding the delivery of health care services, by over-riding Employee#1’s

recommendations on the standard of care for GVHC’s patients, Mr. Weber effectively

engaged in the practice of medicine – endangering the safety of over 100,000 GVHC

patients and the public in general. For clarity, Mr. Weber is not a licensed physician.

Therefore, the Medical Board of California may have a cause of action against Mr. Weber for

the unlicensed practice of medicine.

Furthermore, Mr. Weber has publicly declared that the Board fully supports all his

decisions and actions. If true, the Board may be held personally liable should decline in

patient care result in injuries (or even death). Succinctly, Mr. Weber’s decisions have or

will result in the decline of patient care and quality and may place the health and safety of

tens of thousands of patients at risk. The Board has a fiduciary duty to the public, patients

and providers of GVHC to fully investigate this issue, among others outlined herein.

(3) False Imprisonment of an Employee

As briefly outlined above, Employee#1 may have been falsely imprisoned by Mr.

Weber, Mr. Michael Buda (CHR of GVHC) and Mr. Mark Millan (COO of GVHC) on November

17, 2014. Already previously verbally harassed on November 11, Employee#1 was visibly

upset and anxious and shared with colleagues that she had a last minute one-on-one

meeting with Mr. Weber and if Mr. Buda were present she would fear for her safety2.

Employee#4, having been in a previous meeting with Mr. Weber and Mr Buda where

Employee#4 was verbally harassed and subjected to profanities by Mr Weber while Mr.

Buda silently stood by, volunteered to Employee#1 to be present at the meeting for

support. Employee#1 texted Employee#4 that indeed Mr. Buda was to be present at

meeting and for Employee#4 to come. However, despite having received texted messages

from Employee#4, stating he would come, Employee#4 was physically prohibited from

seeing Employee#1 by Mr. Millan. During Employee#1’s confinement, Employee#4 texted

Employee#1 to inquire whether she was safe. For nearly 3 hours, Employee#1 was

involuntarily locked in a conference room in GVHC’s Merced office by Mr. Weber and Mr.

Buda. In attempt to reach and rescue Employee#1, Employee#4 was confronted by Mr.

Millan. In fact, Mr. Millan physically blocked Employee#4 from reaching Employee#1’s

room and within inches of Employee#4’s face, Mr. Millan ordered Employee#4 to leave the

2 No one should fear for their safety at GVHC. The fact that a CMO feared for her safety speaks volume of the hostile environment and the people that created the hostile environment.

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building. Those who were involved in the willful and false imprisonment of Employee#1,

including Mr. Weber, Mr. Millan, and Mr. Buda, should be prosecuted. It should be noted to

the Board that false imprisonment is a felony offense. Further, failure to report a crime

may subject the Board to personal liability (and may even rise to the level of Class A

misdemeanor in some states). The Board is advised to thoroughly investigate this matter,

which may rise to the level of a felony offense. In any case, such action by Mr. Weber, Mr.

Millan, and Mr. Buda consequently exposes GVHC to civil liabilities and claims.

(4) Violations of Code of Conduct & Laws and Conflict of Interest

Among Mr. Weber’s first actions as CEO was the appointment of his best friend,

Mark Anthony Millan as Chief Operating Officer of GVHC. Mr. Millan was hired as COO,

despite being unqualified to even hold a lower position as Director of Operations for

which Mr. Millan had applied and was denied because Mr. Millan failed to meet the

minimum requirement for the position, which was a bachelor’s degree. GVHC’s normal

operating and hiring procedures require that top executives and clinical leaders to hold at

least a bachelors degree. Therefore, it is unfanthomable and irresponsible (of Mr. Weber)

to appoint a person, who lacked both experience and education, to the position of COO. Mr.

Millan is rumored to hold employment wherever Mr. Weber finds his. Mr. Millan’s

relationship to Mr. Weber (best friends) and his appointment as COO, despite being

unqualified for a lower position, (1) is a clear conflict of interest; (2) violates the code of

conduct of GVHC; (3) depart from historical norms and operating procedures of GVHC; and

(4) reflects poorly on GVHC as an organization of high standards.

Separately, another poor and/or illegal decision of Mr. Weber may be the

appointment of George Conklin, PA-C, as Interim Chief Medical Officer a week after

Employee#1 was wrongfully terminated. Historically, GVHC’s Policies and Procedures

require the Chief Medical Officer to be a board licensed primary care physician, not a

physician assistant. In fact, since the establishment of GVHC, all CMOs have been licensed

physicians. Both Mr. Weber and Mr. Conklin knew or should have known that all previous

GVHC CMOs have been licensed physicians.

Section 330 of the Public Health Service (PHS) Act (42 U.S. Code, Chap. 6A, § 254b)

requires that all FQHCs must have a medical director who supervises all clinical activities

and medical doctors who are licensed and residency-trained. As a physician assistant

(PA), Mr. Conklin is not a licensed medical doctor. In fact, Mr. Conklin’s charts must be co-

signed by a licensed physician. In view of this, a physician assistant may not be

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qualified under Section 330 to supervise licensed medical doctors. Subsequently,

GVHC may be in violation of Section 330 of the PHS Act. Continual violations of Section 330

may affect patient care and quality. As such, failure to address this issue may result in

criminal and civil liabilities to GVHC, including personal liabilities by responsible parties

(e.g., Mr. Weber, Mr. Conklin, and Mr. Buda) and the Board for neglect. Even putting aside

Section 330, it boggles the mind that a staff that needs to be overseen by a licensed

physician is now in fact supervising his supervisors (other licensed physicians). This

further solidifies an ominous concern about the competence of Mr. Weber and Mr. Buda

and those that may have been involved in the decision making process3.

The above violations are serious matters that will ultimately affect patient care and

quality. The Board should thoroughly investigate the hiring and qualifications of Mr. Millan

as COO and the appointment of Mr. Conklin as CMO. Both appear to be violations of conflict

of interest, GVHC code of conduct and other state and federal statutes.

5) Discrimination

During the meeting between providers and Mr. Weber on November 21, Mr. Weber

commented on his strategic goals for GVHC. Mr. Weber denied a strategic plan to change

the direction and Mission of GVHC. However, Mr. Weber’s actions indicate a direct

opposition to GVHC’s current Mission Vision and Core Values, which Mr. Weber himself

could not enumerate in the November 21 meeting with providers.

For example, the following excerpts are from the November 21 meeting:

Attendee#3: Oh, I am sorry, what is the mission vision of Golden Valley? You have been

our CEO for the last 6 months. Sir, what is the mission vision of Golden Valley?

Mr. Weber: I am not gonna get into this…

Attendee#3: But sir, we need to see that your mission is aligned with what we’ve been

here for us for the past 10 years.

3 As Chief of HR, Mr. Buda knew or should have known that Mr. Conklin’s appointment was illegal and will or has affected patient care and quality. As such, both Mr. Weber and Mr. Buda may be personally liable for their illegal actions. Further, by accepting the position, Mr. Conklin may be subjected to disciplinary actions by the Physician Assistant Board of California for practicing medicine outside the scope of his license (i.e., unlicensed practice of medicine).

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Mr. Weber: It’s about the patient, okay? It’s about patient experience, it’s about quality,

it’s about moving us forward, to deal with the changes and deliver... these things have

been talked about, it before I got here. There’s big changes in the horizon, we need big

leadership to take us there. My strategic vision hasn’t changed, it’s all about the patient,

it’s all about access too, it’s all the quality.

Accessible to everyone, GVHC’s Mission is concisely written on GVHC’s website as:

“The mission of Golden Valley Health Centers is to improve the health of our patients by providing quality, primary health care services to people in the communities we serve regardless of language, financial or cultural barriers.”

Repeatedly, Mr. Weber has expressed a desire to become the premier employer of

choice and healthcare provider of choice. This is not GVHC’s Vision. In fact, as stated on

GVHC’s website (which Mr. Weber can access), the Vision of GVHC is as follows:

“Golden Valley Health Centers will be known as a premier organization ensuring access to high quality, culturally responsive and comprehensive primary health care for all, especially the underserved.”

Further, when asked about GVHC’s core values, Mr. Weber could not recite a single

Core Values of GVHC4, as demonstrated in the following exchanges during the November 21

meeting:

Audience: If you could just mention the core value...

Mr. Weber: Trust, honesty, integrity…

Attendee#3: Those are not in our email sir.

Mr. Weber: You guys put it in a context of how your relationship with doctor….

Attendee#3: Sir, you did not mention a single core value…

4 GVHC Core Values are: Advocacy, Access, Efficiency, Respect, Innovation and Excellence.

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The above demonstrates that Mr. Weber has no understanding or grasp of

GVHC’s Mission, Vision, or even its Core Values. I respectfully repeat: Mr. Weber was

unable to recite or summarize GVHC’s Mission, Vision and Core Values (not even a single

Core Value). A CEO should be able to recite, without notice, the Mission, Vision and Core

Values of the organization that he/she leads. Therefore, as a primary care provider in a

health center, I am worried that the real intent, the true objective of Mr. Weber is to change

the atmosphere, including the 1) patient demographic, removing access to healthcare to a

predominantly Hispanic population composed of migrant farm workers, and consequently

2) the staff physicians, discriminating against Foreign Medical Graduates and visa

physicians.

Noticeably, Mr. Weber is unaware that one of the Core Values of GVHC is RESPECT.

This, along with Mr. Weber’s inability to recite or summarize GVHC’s Mission, Vision and

Core Values, doomed Mr. Weber from the very beginning and lead to the creation of a

hostile work environment, which ultimately resulted in discrimination or lead others to

discriminate.

For example, enclosed you will find a copy of a letter written by Employee#9,

addressed to the Board, describing an incident in July 2014, involving herself and Mr. Buda,

wherein Mr. Buda verbally expressed racist and discriminatory comments against

foreign medical graduates. More specifically, Mr. Buda stated the following: “that doctors

of foreign countries do not receive adequate medical training and GVHC does not want to

have a reputation for hiring lesser qualified physicians.” Inconceivably, these are words

from the highest officer of Human Resource himself, a lawyer who should be held liable for

his words to the State Bar of California. During the provider meeting on November 21,

instead of denying or disavowing the statement, Mr. Buda has stated that he does not recall

the conversation (multiple times). Despite Mr. Buda’s selective memory, a number of GVHC

staff can corroborate Mr. Buda’s discriminatory and hurtful statement.

As a foreign medical graduate, I am disgusted and insulted at the blatant

discrimination against foreign medical graduates by Mr. Buda, who may have violated one

or more attorney ethics rules with his racially charged and discriminatory statement. In

fact, Section 330 of the PHS Act requires FQHCs to design culturally and linguistically

appropriate health services programs. GVHC relies on foreign medical graduates and

the foreign language training of foreign graduates in order to meet the requirements of

Section 330. I myself speak medical Spanish, in addition to English and Tagalog, and my

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ethnic background includes Filipino, Chinese and German.5 Many of GVHC’s foreign

graduate providers have similar diverse background and speak multiple languages as well.

This is what makes GVHC great – our culturally and linguistically diverse group of

providers.

Mr. Buda’s statement, therefore, should be unequivocally rejected by the Board. The

Board should thoroughly investigate and, if applicable, institute corrective and disciplinary

actions that will support current labor laws, including state and federal statutes governing

discrimination, and the Mission, Vision and Core Values of GVHC.

6) Impact to Health Care and Patient Care & Quality

But of all the events in the past six months, nothing empowered providers more

than the wrongful termination of a much loved and respected CMO, Employee#1, graduate

of Stanford Medical School. Employee#1, a pillar of strength in the Hispanic community, is

the sitting president of the Stanislaus Medical Society, board member of Doctor’s Medical

Center Hospital (serving over 220,000 patients), board member of Latino Physicians of

California, and is revered and respected by her peers (throughout the State of California).

In fact, Employee#1 was formerly the first Latina member of the California Medical

Board. Employee#1 is also beloved by her patients. Employee#1 is the primary care

physician to over 2000 patients and was wrongfully terminated for, among others, her

opposition to Mr. Weber’s decisions affecting patient care and quality. Although GVHC will

likely bear the legal consequences of Mr. Weber and Mr. Buda’s ill-advised actions and

decisions, I and other providers cannot stand silently against the injustice and oppression

of Mr. Weber and Mr. Buda as their actions and decisions have and will impact patient care

and quality.

Our most pressing concern is the astoundingly negative impact to health care as a

direct consequence of Employee#1’s wrongful termination. Employee#1 was abruptly

terminated on a Monday, in between seeing patients. This resulted in an immediate lack of

access to healthcare because Employee#1’s patients were not adequately informed, nor

were the patients given provision of care in a timely manner afterwards. Hordes of patients

complained on a daily basis, but even with mounting grievance reports, we saw no

immediate action to respond to this outcry.

5 As to my family, I have in-laws who are Vietnamese, Chinese, Malaysian, Filipino, Hispanic, Caucasian, and African-American.

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Further, the medical staff at 6th St GVHC clinic were instructed eight days after

Employee#1’s termination to inform Employee#1’s patients inquiring about her departure

that ‘it was a mutual decision to separate’. All these lies (which violates GVHC code of

conduct), and the gross negligence in provision of care reflect the callous uncaring and

arrogant disposition of a Chief Executive Officer (Mr. Weber) in a Federally Qualified Health

Center. It would be reasonable for the Board to question Mr. Weber and/or Mr. Buda as to

their involvement in the deceptions of Employee#1’s patients. Mr. Buda, as a licensed

California attorney, is governed by strict attorney ethics rules and the State Bar should

investigate as well.

Again referencing the meeting between providers and the CEO on November 21, Mr.

Weber enumerated all the outstanding qualities of Employee#1 as a primary care provider.

Mr. Weber described her as a terrific physician and expressed how he feels terrible for her

patients. And yet, when questioned if he would consider hiring her as a physician, his

answer was an emphatic ‘no’. I cannot overemphasize the crucial impact this arrogant

decision is to the health of thousands of people whose families have her as Primary Care

Provider for over three generations.

Regardless of how one feels about Employee#1’s wrongful termination, her

departure affected over 2000 patients and is effectively patient abandonment since Mr.

Weber had no back-up plans to care for Employee#1’s patients. In fact, GVHC may be

obligated to give notice of a provider’s departure to patients within a certain period of time

following a provider’s departure. To my knowledge, no such notice was given to any

patients of Employee#1.

As an example of how patient abandonment has real and material consequences to

both GVHC and the Board, consider the following scenario. A patient of Employee#1,

unable to get an appointment, ends up in the ICU due to a lack of an insulin prescription. In

such a case, the patient may have a cause of action against GVHC for malpractice.

Furthermore, through the ordinary course of discovery, documents may be uncovered to

demonstrate that the Board knew or should have known about the patient abandonment

issue following the wrongful termination of Employee#1. As a result, the Board may be

found personally liable for neglect of fiduciary responsibilities (in addition to personal

liabilities by Mr. Weber and potentially Mr. Buda).

The decaying of quality of patient care is publicly visible under the leadership of Mr.

Weber. The Board must take immediate corrective actions to restore patient care quality

and confidence in GVHC as a premier health care center for the underserved.

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7) Violations of State and Federal Law

Federally Qualified Health Center (“FQHC”) is a designation the federal Bureau of

Primary Health Care (BPHC) and the Centers for Medicare and Medicaid Services (CMS)

assigned to private nonprofit or public health care organizations that serve predominantly

uninsured or medically underserved populations.

All FQHCs must be governed by a consumer board of directors and provide

comprehensive primary health, oral, and mental health and substance abuse services to

persons in all stages of life. FQHCs offer their services to all persons regardless of ability to

pay and charge for services on a board-approved sliding fee scale based on patients' family

income and size. FQHCs must comply with Section 330 program requirements and all

applicable state and federal regulations.

FQHCs are required to meet certain health care services requirements. For example,

all FQHCs must have a medical director who supervises all clinical activities and

medical doctors who are licensed and residency-trained. However, as previously

mentioned, Mr. Weber recently appointed a physician assistant, Mr. Conklin, as the CMO of

GVHC. Given that the CMO position is not a purely administrative position (as required by

Section 330), I believe such appointment is illegal and may violate Section 330 of the

Public Health Service Act. Further, as the CMO, Mr. Conklin may be practicing medicine

outside the scope of his license as a PA. Such violations should be reported to the Physician

Assistant Board of California for disciplinary action. In the event that Mr. Conklin and/or

Mr. Weber argue that Mr. Conklin’s appointment as CMO is an administrative position, then

Mr. Weber has willfully allowed GVHC to be noncompliant under Section 330, which may

disqualify GVHC from FQHC status. Regardless of the intentions of Mr. Weber or Mr.

Conklin, both may have violated federal laws governing FQHC and state board regulations.

Further, as the CHR, Mr. Buda may have assisted or been involved and therefore should be

the subject of an investigation into this matter as well. A thorough investigation by the

Board is respectfully requested to protect GVHC from further harm and liabilities.

In summary, it is my hope that all Board members take the issues outlined herein

seriously and thoroughly investigate all allegations of misconduct or violation of laws.

Board members can be liable for the consequences of decisions if they neglect their

responsibilities as Board members. Further, Board members can be personally liable

in matters involving a conflict of interest or violations of local, state or

federal criminal laws.

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Given that litigation and/or investigations by government and board authorities are

eminent, the Board should consider instituting a litigation hold order to preserve all

forms of relevant information and evidence that may be relevant in eminent litigation

and investigations by local, state and federal authorities, including medical boards and

state bars. In view of the above issues, litigation and investigations by government and

board authorities are reasonably anticipated. The Board, therefore, should consider

instructing Mr. Raymond Parris, Chief Information Officer of GVHC, and GVHC legal

counsels to initiate a notice or communication to those who may be in custody of relevant

information and evidence to preserve all forms of relevant information and evidence,

including GVHC as an organization, where GVHC is legally obligated to suspend the normal

disposition or processing of records, such as backup tape recycling, archived media and

other storage and management of documents and information. For Mr. Weber, Mr. Millan,

and Mr. Buda, it may be advisable for GVHC and Mr. Parris to secure GVHC assets (e.g.,

computers and phones) from Mr. Weber, Mr. Millan, and Mr. Buda to ensure full compliance

with laws and regulations. Failure to act quickly to prevent the destruction of evidence and

secure custody of relevant discoverable information may result in evidence spoliation,

which may result in exemplary and punitive sanctions against the responsible parties.

Lastly, the Board may want to consider whether it is appropriate to place Mr.

Weber, Mr. Millan, and Mr. Buda on administrative leave pending the outcome of the

investigations into the serious matters outlined herein. Further, in the event local, state,

and/or federal authorities, including medical boards, state bars, and law enforcement,

decide to take investigative or other actions against Mr. Weber, Mr. Millan, and Mr. Buda, it

may be advisable for the Board to move to ensure GVHC resources are not used to

represent and/or defend Mr. Weber, Mr. Millan, and/or Mr. Buda as these executives are

personally liable and accountable for their actions and decisions, especially actions and

decisions that have violated GVHC code of conduct or state and federal laws.

I sincerely thank you for your attention to these matters and your services as Board

members of GVHC. I and the entire GVHC staff look forward to hearing from the Board on

the progress and outcomes of the investigations into these matters.

Respectfully Submitted,

More than 150 Golden Valley Health Centers Providers, Staff and Patients.