Link to hospitals with stake in health reform criticized.

Sacramento Bee (California)

Shortly after Assembly Speaker Fabian Núñez became a point man in the fight to expand health care for the uninsured, his wife accepted a lucrative job with close ties to hospitals that have a massive financial stake in such reform.

Maria Robles was hired as president of the nonprofit Californians for Patient Care in January, one month after Núñez introduced a bill declaring his intent to provide “affordable, quality health care coverage” to all Californians.

State law does not bar Robles from such employment, but it means that much of her salary — which apparently exceeds $100,000 — stems from contributions to the nonprofit agency by a powerful special interest that stands to gain billions if Núñez’s health care efforts succeed.

Robles said she has never discussed health care reform with her husband.

“Fabian and I have this agreement,” she said. “First of all, we don’t see each other very much. When we do, we don’t talk business. We just can’t. The marriage would never survive.”

But Bob Stern, president of the Center for Governmental Studies in Los Angeles, said Robles’ job can create the perception that special interests are paying Núñez indirectly.

“It certainly doesn’t hurt them to have a financial relationship with his wife, even if she’s doing absolutely nothing to influence Núñez,” Stern said. “He has to know where the money is coming from.”

Californians for Patient Care says its goal is to “preserve and improve a health care system that will be available when you, your family members or your friends and neighbors need it most.”

The 3-year-old nonprofit agency does not employ lobbyists and makes no political contributions, records show.

Robles supervises a two-person staff whose primary job is to create a database of health care resources for Californians who lack private insurance. Her role also involves soliciting funds for future years, although she has not yet begun to do so, she said.

State law requires Robles to disclose her employment to the Fair Political Practices Commission, but not until March, more than a year after the latest health care debate began.

Robles declined to provide her salary, but she replaced Kristine Yahn, who received more than $140,000 per year, records show.

Núñez defended the right of his wife, a registered nurse, to accept the job.

“She’s been in the (medical field) longer than you and I have been talking about health care,” Núñez said. “And she’s not been involved in policy in any way, shape or form.”

Doug Heller, executive director of the Foundation for Taxpayer and Consumer Rights, said bankrolling a job for the wife of a legislative leader can do more for a special interest than a campaign contribution would.

“This is lifestyle protection,” he said. “It’s a way to provide personal financial benefits to a politician whose votes you depend on.”

In announcing Robles’ hire, Californians for Patient Care touted both her “political acumen” and her nursing expertise in emergency room care, oncology, pulmonary medicine, research, utilization and case management.

The group is not legally required to report its donors, and Robles declined to do so voluntarily. But by all accounts, the Sacramento nonprofit agency has close ties to the California Hospital Association.

C. Duane Dauner, president of the association, said his group worked with others to create the nonprofit agency in 2004, “because we felt it was important for there to be an organization to speak for patients.”

Dauner said he doesn’t know precisely what percentage of Californians for Patient Care’s funding has come from his group.

“But we’ve given a substantial amount of it,” said Dauner, whose association represents 450 hospitals and health systems.

The California Nurses Association, in a bulletin for members, characterized Californians for Patient Care two years ago as a “hospital industry front group.”

“Now, to have (Núñez’s) wife in a position to essentially lobby for the hospital industry, we think it’s an enormous specter of concern,” Executive Director Rose Ann DeMoro said.

Several times this year, Núñez’s votes benefited hospitals and hurt patients — including his support for Senate Bill 306, allowing hospitals to extend by seven years a deadline for meeting seismic safety standards, DeMoro said.

Steve Maviglio, Núñez’s spokesman, countered that the nurses association was the only organized opposition to SB 306, which received bipartisan support.

Maviglio, in a written statement, said Robles’ job has had no impact on Núñez’s votes and “it’s absurd that the speaker’s political enemies are trying to connect those dots.”

He noted that in politics, it is not necessarily rare for a legislator’s spouse to work in a job involving public issues.

David Townsend, a political consultant for the California Hospital Association, said his firm recommended Robles for the nonprofit post after she worked effectively on last year’s tobacco tax initiative. That unsuccessful campaign was spearheaded by the hospital association.

Townsend described Robles — paid nearly $100,000 as a Proposition 86 consultant — as a perfect fit for the nonprofit job.

“She’s articulate, hard working, attractive, bilingual and she knows health care inside and out,” Townsend said. “She’s the whole package.”

Dauner said he also recommended Robles for the nonprofit job.

Jane Hirsch, a nursing professor and member of the Californians for Patient Care governing board, applauded Robles’ performance.

“In my experience, she’s very well qualified and has been very energetic and really done an amazing amount of work,” Hirsch said.

Núñez’s health care legislation, Assembly Bill 8, was a lightning rod for Capitol debate but ultimately was vetoed by Gov. Arnold Schwarzenegger.

The bill would have placed the onus on employers, not hospitals, to expand health insurance. Maviglio noted, however, that hospital officials have expressed numerous other concerns about the bill.

Schwarzenegger’s health care plan, which has not been accepted by lawmakers, calls for the financial pain to be shared by employers, employees, insurers and government. He negotiated an agreement with the hospital association in which the latter would pay 4 percent of its revenue up front, with an expectation that they would be reimbursed with federal funds.

The California Hospital Association is a major contributor to both parties. Months ago, it donated $100,000 to Proposition 93, a term limits measure pushed by Núñez that would allow him to remain in power six extra years.

Robles, besides campaigning to pass Proposition 86, served as a consultant for the South Coast Air Quality Management District. She organized asthma conferences for the group this year and in 2006.

Robles’ political ties apparently came in handy: Keynote speaker for the 2006 conference was Los Angeles Mayor Antonio Villaraigosa, Núñez’s close friend. This year’s conference featured addresses by Núñez and Schwarzenegger.