--- [ LOS ANGELES ](https://mail.citywatchla.com/index.php?option=com_content&view=category&id=312) # LA Public Health Is Very Sick Written by Eliot Cohen. ![](https://mail.citywatchla.com/images/stories/Aug-2026/065f.jpg) August 17 2026 [](https://www.addtoany.com/share) [Comments](#disqus_thread) MAKING THE CASE - The Los Angeles County Department of Public Health (LACDPH) should be renamed the Department of Ill Health. For nearly a decade, Barbara Ferrer, who is not a medical doctor, has presided over one of America's largest and most powerful local public-health bureaucracies. During COVID-19, Los Angeles residents discovered just how powerful it could be. Businesses were closed. Restaurants were prohibited from serving customers outdoors. Schools operated under sweeping restrictions. Beaches and recreational facilities were closed or restricted. Masks were mandated. Vaccination was promoted relentlessly. We sat in the car in long lines to have our noses swabbed so we could go to work. Ferrer's department demonstrated little hesitation about regulating the daily lives of millions of people. Because of The Science™ and The Public Health™. LACDPH became so concerned with individual medical compliance that a bartender had to [prove vaccination status](https://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=3483) before working indoors, a customer had to show proof of vaccination and photo identification to enter a bar, and thousands attending major events had to present vaccination records or [negative test results at the gate](https://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=3412). Now, suddenly, the Department of Public Health has become a toothless tiger. Look at the scorecard. In 2025, Los Angeles County recorded [220 cases of flea-borne typhus, the highest on record](https://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=5291). That surpassed the previous record of 187, set just one year earlier. Nearly 9 out of 10 identified typhus patients in 2025 required hospitalization. Tuberculosis cases reached [554, the county's highest since 2016](https://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=5282). Los Angeles County declared a [countywide hepatitis A outbreak](https://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=5025). LACDPH has described the drug epidemic facing Los Angeles as “the worst overdose crisis in our history.” Typhus. Tuberculosis. Hepatitis. Fentanyl and Meth, oh my! Perhaps somebody should inspect the Health Department. The nursing-home record is a good place to start. Long before COVID, LACDPH's nursing home inspection program was already failing. An [April 2014 County audit](https://file.lacounty.gov/SDSInter/auditor/cmr/1009298_2014-04-04DepartmentofPublicHealth-NursingHomeInvestigationAudit%28BoardAgendaItem49-A%2CMarch4%2C2014%29.pdf) found 3,044 open investigations, including 945 that had been unresolved for more than two years. A [follow-up audit that August](https://file.lacounty.gov/SDSInter/auditor/cmr/1009301_2014-08-27DepartmentofPublicHealth-NursingHomeInvestigationFollow-UpReview%28BoardAgendaItem49-A%2CMarch4%2C2014%29.pdf) examined 30 closed cases and found that five had been improperly closed without completing required investigations. In 12 of the 30 closed cases reviewed, supervisors deleted or downgraded inspectors' recommended deficiencies or citations. Nine of those 12 files lacked documentation supporting the changes, and four weren't even discussed with the inspectors as required. Most disturbing, five of the 12 cases involved resident deaths. In five cases, the district manager who deleted or downgraded the findings couldn't provide justification. Ferrer didn't create this mess. She inherited it when she became director in 2017. She had three years before COVID to address them. Nursing-home residents then accounted for 58 percent of county COVID deaths during the summer of 2020. Five years later, the county is still demanding implementation of 52 recommendations to improve the inspection operation. But that raises the more important question: What did she do with the three years she had before COVID arrived? [State statistics showed nursing-home complaints](https://www.latimes.com/local/california/la-me-nursing-home-investigations-20150517-story.html?utm_source=chatgpt.com) remained open an average of 352 days in Los Angeles County compared with 255 days statewide. Los Angeles generated roughly 23 percent of the complaints but accounted for approximately 56 percent of California's open complaints. During the summer of 2020, an astonishing [58 percent of all Los Angeles County COVID deaths were among skilled-nursing-facility residents](https://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=4911). Over the course of the pandemic, LACDPH later reported that more than [6,000 skilled-nursing-facility residents died from COVID](https://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=4911). Protecting that population was one of Public Health's most important responsibilities. In May 2020, the Board of Supervisors was concerned enough to order an Inspector General review of nursing-home oversight. The Board was particularly concerned that inspection personnel had been diverted and that serious quality-control problems might be worsening without appropriate intervention. And the problems didn't end with COVID. A later independent assessment of LACDPH's Health Facilities Inspection Division generated [52 recommendations](https://file.lacounty.gov/SDSInter/ceo/agendas/1179127_FinalAgendaPacket03.19.2025.pdf) involving staffing, productivity, management, recordkeeping and training. In 2025, the Board of Supervisors was still directing Ferrer to implement those recommendations and report on the department's progress. Then there is flea-borne typhus. LACDPH acknowledges [cases have been increasing since 2010](https://publichealth.lacounty.gov/acd/diseases/Typhus/Index.htm). Los Angeles set a record with 187 cases in 2024 and promptly broke it with 220 cases in 2025. What would real public health look like? The Board of Supervisors has already identified Willowbrook, Westlake, and Santa Monica as particularly affected. LACDPH is identifying localized clusters. Now combat the environmental conditions that sustain them with the same urgency as during the COVID pandemic. Attack accumulated garbage, food waste, and conditions that attract rats and other animals. And stop pretending that encampment sanitation is somebody else's homelessness problem. When every street is an open-air food bazaar with 20 different hygiene standards, with food waste, rodents, fleas, and free-roaming animals all concentrated together, that is an infectious-disease environment. Cleaning it up is a matter of public health and common sense. Yet in 2026, after years of increasing cases and two consecutive records, the Board of Supervisors itself was calling for stronger prevention and response efforts. Why did the response still need strengthening? Why is Dr. Barbara (not an MD) dragging her feet? This is where the hypocrisy becomes difficult to miss. During COVID, Public Health imposed enormous burdens on ordinary residents and businesses. Today, people suffering from profound mental illness live on sidewalks. Fentanyl and methamphetamine are consumed openly. Garbage, human waste and discarded drug paraphernalia coexist with encampments. People deteriorate publicly from addiction, psychosis, wounds and disease. Suddenly government discovers restraint. Now we hear about jurisdictional boundaries, individual autonomy, outreach, housing and “meeting people where they are.” Where did all that public-health urgency go? LACDPH can't independently clear every encampment or involuntarily institutionalize every mentally ill or addicted person. But it can sound the alarm. It can identify dangerous environmental conditions. It can demand action. It can pressure the Board of Supervisors, the Mayor, the City Council, LAHSA, and other agencies with the same intensity it once directed at private businesses. Perhaps confronting another government bureaucracy is harder than confronting a restaurant owner, especially when that municipality pays your overly generous salary. Why has the Dept. of Health been virtually invisible in addressing these visible issues? The department's own materials state that [getting people to stop using drugs “is not the main objective of harm reduction.”](https://publichealth.lacounty.gov/sapc/public/harm-reduction/) So if you don’t provide a way for street addicts to stop smoking super meth and shooting up, how can there be real harm reduction? County-supported programs can provide sterile syringes, sterile water, filters, smoking supplies, and fentanyl test strips. LACDPH uses a [needs-based syringe model](https://publichealth.lacounty.gov/sapc/public/harm-reduction/) with no numerical limit and no requirement to return used syringes. Advocates correctly point out that syringe programs can reduce HIV and hepatitis transmission and connect users with services. But when harm reduction reduces secondary infections while the street addict remains at risk of dying from an overdose, it is like throwing a cup of water on a three-alarm fire and calling it firefighting. A federal single-audit finding involving a Public Health Emergency Preparedness program found that DPH [couldn't provide procurement history](https://auditor.lacounty.gov/wp-content/uploads/2021/10/FY19-20-Single-Audit-Report.pdf?utm_source=chatgpt.com) documentation for 21 contracts, preventing auditors from determining compliance with procurement methods, competition, and the basis for contract pricing. The department subsequently corrected the issues. But this was the same bureaucracy demanding meticulous compliance from millions of residents while auditors couldn't verify basic compliance documentation in its own contracting operation. Then there is “Dr.” Barb. She has earned an academic title. Ferrer holds a Ph.D. in social welfare. Los Angeles County's statutory Health Officer, Muntu Davis, is. Yet Ferrer became the overwhelmingly visible face of medical policy affecting millions of people during COVID. Where did Davis's independent medical authority end and Ferrer's administrative authority begin, and what happened if the physicians disagreed with the director? Was there ever any rigorous debate about COVID policy? The department's treatment of critics raises another question about institutional culture. Litigation brought by the Alliance of Los Angeles County Parents challenged LACDPH's handling of social media comments and communications on Twitter. The county ultimately won. The court did not find that plaintiffs proved viewpoint discrimination or improper coercion of Twitter. But evidence showed Ferrer personally decided to close public comments. Because nothing says The Science™ is settled more than silencing critical debate. Internal communications referred to critics as “anti-maskers” and a “right-wing echo chamber.” Another awkward episode involved Ferrer's daughter, Kaitlin Barnes, who [coauthored published research examining COVID case rates in Los Angeles County schools](https://pubmed.ncbi.nlm.nih.gov/34473679/). Unlike the other authors—whose listed credentials included an M.D., a Ph.D., and two M.P.H. degrees. Barnes's listed credential was an M.B.A. Ferrer denied participating in the research, and there is no evidence the study was fraudulent. But for an administration that relentlessly tells residents to “trust the science,” What qualified the Public Health Director's daughter for such a prominent authorship role? Finally, there is the price tag. According to Los Angeles County's August 2026 Department Head Salaries schedule, Barbara Ferrer's annual salary is approximately $581,949. For nearly $582,000 a year, taxpayers are entitled to exquisite management. Barbara Ferrer's Department of Public Health has spent years grading everybody else. It graded restaurants. Businesses. Schools. Workers. Our behavior. Our vaccination status. Now consider the Department of ill health. Procurement controls problems. Nursing-home oversight: years of documented problems, followed eventually by 52 recommendations for improvement. Flea-borne typhus: consecutive all-time records. Tuberculosis: highest level since 2016. Hepatitis A: countywide outbreak. There are approximately 44 drug overdose deaths per week in Los Angeles County, based on the [Los Angeles County Department of Public Health](https://lacounty.gov/2026/06/25/drug-related-overdose-deaths-in-la-county-continue-to-fall/) records: what LACDPH itself calls the worst overdose crisis in county history. And the number of street addicts is up 8%. These numbers are a disaster. Ferrer is an administrator. So, let's judge her on what she is actually paid to do: manage health. If Los Angeles is getting sicker, maybe it's time for a management overhaul. What exactly are taxpayers getting from a Public Health Department with a budget of [$1.8 billion](https://file.lacounty.gov/SDSInter/bos/supdocs/218239.pdf?utm_source=chatgpt.com) besides a sprawling bureaucracy that rigorously regulates permitted restaurants while unpermitted street-food vendors do whatever they want? Los Angeles is very sick. And the Department of Public Health deserves a failing grade. *(**Eliot Cohen** is a longtime civic advocate who has served on the Neighborhood Council, the Van Nuys Airport Citizens Advisory Council, and the Board of Homeowners of Encino, where he was president of HOME for over seven years. A retired Wall Street executive with a 35-year career, Eliot brings a sharp eye to local governance. He critiques the bureaucratic missteps of City, County, and State officials. Eliot and his wife split their time between Los Angeles and Baja Norte, Mexico.)* [![](https://mail.citywatchla.com/images/ME%20DENTAL%20SPA/me%20dental%202026%20final.jpg)](http://medentalspa.com/) ![](https://mail.citywatchla.com/images/banners/signup-for-cw.png) ## Get The News In Your Email Inbox Mondays & Thursdays First Name [ ![LA DWP #2 (Pay Your Bill Help)](https://mail.citywatchla.com/images/LADWP/dwp%20level%20pay%205-7-25.jpg) ](https://mail.citywatchla.com/component/banners/click/82 "LA DWP #2 (Pay Your Bill Help)") [ ![Home - HHR Rent is too High - SB-2](https://mail.citywatchla.com/images/HHR/AHF-rent-too-high.jpg) ](https://mail.citywatchla.com/component/banners/click/104 "Home - HHR Rent is too High - SB-2") --- ## Featured CityWatch Stories [ ![](https://mail.citywatchla.com/media/yootheme/cache/34/065h-34e1b43b.jpg) ](https://mail.citywatchla.com/index.php?option=com_content&view=article&id=33212:reminder-to-the-red-states-turnabout-is-fair-play&catid=395) ### [Reminder to the Red States, Turnabout is Fair Play](https://mail.citywatchla.com/index.php?option=com_content&view=article&id=33212:reminder-to-the-red-states-turnabout-is-fair-play&catid=395) GELFAND’S WORLD - Indiana has been pounded by rains that resulted in widespread flooding. 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