Photo by Jack GouldDespite recently admitting under oath that he gave bogus injections to at least one AIDS patient, Dr. G. Steven Kooshian is seeking to take over Orange County's public AIDS programs.
Kooshian—who is also under investigation by the state's medical board on a variety of misconduct charges—applied early this year to win an unpublicized $2.8 million annual contract to run the county's AIDS care facilities in Santa Ana and Laguna Beach, according to county records. The two facilities serve more than 1,200 patients. Three other medical operations are in the running against Kooshian: AIDS Healthcare Foundation of Los Angeles, Laguna Beach Community Clinic and UC Irvine.
Orange County health-care officials—some of whom were noticeably annoyed by the Weekly's attention to their plans—say they have established no time line for a decision and may ultimately kill the AIDS privatization plan.
"Nothing has been decided yet," said one official. "And there is nothing unusual going on. We are just exploring the idea."
But the Kooshian bid is indeed unusual: the controversial doctor has inside help in his effort to win the government contract.
The chairman of the county's powerful HIV Planning Council—which officially tells the county how to spend $6 million in federal AIDS grants each year—is Ron Viramontes. The 38-year-old Viramontes is the financial administrator for Kooshian's four medical offices. He is also Kooshian's lover. The two men share a massive five-bedroom, $3.6 million Newport Coast estate as well as a taste for top-of-the-line Mercedes Benzes and Porsches, which fill their 1,000-square-foot garage.
Records show that Viramontes lobbied several times on Kooshian's behalf with TIPPS Consulting Services, the county's private consultant on the feasibility and impact of privatizing AIDS services. On March 28, for example, he sent to TIPPS's Scott Helberg a two-page letter describing Kooshian's interest. The letter espouses Kooshian's qualifications but fails to mention the doctor's criminal history or current legal woes.
"I represent the physicians and staff of Valley View Internal Medicine and Ocean View Internal Medicine and wish to express our interest in the possibility of being a contractor for the County of Orange to provide HIV primary and specialty care services to persons eligible to receive Ryan White [federal AIDS grants] for services in the County of Orange," Viramontes wrote. "We look forward to working with you and the county on developing an outsource model for the provision of primary and specialty HIV medical care."
By using his insider position to lobby for what would be a highly lucrative contract for his lover, Viramontes may have run afoul of his organization's ethics guidelines. According to the HIV Planning Council's policies, "as a rule, members should not involve themselves in any council action that could materially benefit them personally, their business interests, or the interests of organizations they represent."
The county's Health Care Agency (HCA) also has guidelines for contract proposals, one of which requires its officials to assess "the availability or willingness of potential bidders to provide services." But according to the agency's own documents, the search for HIV specialists apparently began and ended with Kooshian.
The Weekly called Bonnie Birnbaum, HCA's manager of HIV Programs, to find out why Kooshian was the only HIV specialist contacted in advance. Birnbaum declined to take the call; her assistant, Chris Prevatt, also declined to answer any questions on the record.
Sources say potential conflicts of interest don't end there. In addition to his business and personal ties to Kooshian as well as his key role at the HIV council, Viramontes also may help to decide if Helberg continues as a county consultant.
County officials did not provide the Weekly with a copy of Helberg's contract. But this much is clear: Helberg is the Las Vegas-based co-owner of TIPPS Consulting and Open Door to the Soul. In addition to the County of Orange, Helberg's other clients include Soul Astrologer; "And They're Off," a horseracing tip sheet; and Witchstar.com's Lady Brenda, an online "High Priestess," founder of the Grove of the Green Cobra and author of The Way of the Witch.
Helberg's May 1 "Final Report" was available online—not through the county, but through his OpenDoortotheSoul.com—until the Weekly contacted the consultant for comment. Helberg refused to be interviewed and within hours blocked public access to his Orange County HIV study by adding a password protection. Ironically, he describes his website as "a place where people come together in spiritual community to share information, ideas, philosophies and to find acceptance and tolerance."
Pat Markley, an HCA spokeswoman, said the county has not released the two-month-old report because it is "still under review."
"It is my understanding that we are tweaking the document now," she said.
Despite the bizarre secrecy surrounding such a key public policy issue, the link between Helberg and Kooshian's office is indisputable. The consultant gave special thanks in his report to Viramontes for his "key" assistance in developing the privatization plan. However, the report's appendices show that Kooshian received relatively low scores in a confidential survey of county HIV patients. In his conclusion, Helberg made a non-binding recommendation that favored UCI over Kooshian.
"Multiple providers with equal or greater experience and capacity have been identified," wrote Helberg. "Consequently, this excludes Dr. Kooshian's medical practice from consideration."
Despite the apparent setback for Kooshian, numerous key Orange County health-care experts—including other local AIDS physicians—are frustrated that the HIV council is not obeying its stated policy of "open, honest" communication with the public. They say county records confirm that Kooshian was given special treatment. Not only was he the only HIV doctor permitted to bid on the privatization plan, but he was also the lone HIV doctor informed of the county's plans.
One observer had a two-word explanation for Kooshian's peculiar insider access: "Ron Viramontes."
"It doesn't take a genius to figure out that something stinks here," said one HIV expert. "Most everything is being done behind-the-scenes with very little public disclosure or debate. It's like they don't want anyone to know what is going on."
Last year, Virgil Opinion—Kooshian's longtime nurse—quit and notified Bryan Noble, a former Kooshian AIDS patient, that the doctor had secretly fed him fake injections instead of the intravenous immunoglobulin he was prescribed. Two civil lawsuits arose and revealed additional allegations that the doctor also sold worthless, expired drugs and gave other unsuspecting patients suboptimal doses of expensive, critical drugs.
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The doctor and his lawyers have strenuously denied wrongdoing. Under oath during an April deposition, however, Kooshian—who was arrested 11 years ago by Newport Beach police for illegally selling steroids to individuals who were not his patients—conceded his role in the bogus shots scheme.
In a July "paid advertisement" in The Blade, a local gay publication that counts the doctor among its top advertisers, Kooshian flip-flopped again and denied he made any admission of wrongdoing during the deposition. (Court records obtained by the Weekly contradict Kooshian's latest version of events.) In the ad, he described himself as "a concerned and caring physician" who has been victimized by "unethical and inappropriate" reporting. Both lawsuits against the doctor are ongoing.
Despite repeated attempts to interview Kooshian and Viramontes for this story, neither cooperated.
(Past articles about this controversy can be seen in online archives at www.ocweekly.com; type "Kooshian" in the search engine.)