Every year, San Diego County spends more than $2 billion a year on contracting, roughly a quarter of its more than $9 billion budget.
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But when it comes to what thousands of contractors are doing with taxpayer money, there are few countywide standards for keeping an eye on them, according to a new review of county contracting practices.
The review — commissioned by the county in March and conducted by outside auditors — shows the county has few overarching rules or criteria for monitoring how contractors are performing and what sort of risk they pose to operations.
The review, released on Monday, repeatedly calls out the “decentralized” approach to contracting compliance, leading the county’s sprawling network of departments and agencies to draft and apply their own rules with little oversight or consistency.
What’s more, the review found there is no countywide system in place for staff to report when a contract is failing to meet expectations or any other contractor performance issues.
“There is no compliance coordination or oversight across the county,” the review says. “Without a countywide framework establishing minimum monitoring standards, the county’s ability to demonstrate consistent, transparent and well-controlled contract governance across departments is limited.”
The review examined both how the county awards contracts as well as how it monitors a contractor’s performance over the course of the agreement.
Despite its criticisms of contract monitoring, the 40-page review also commends county policies for putting contracts out to bid and awarding them
Per the review, the county has a clearly defined bid selection process, training for staff and rules for who has authority over contracting decisions.
“The county has established a sound procurement foundation,” the review said.
That conclusion leaves major questions about what prompted the review in the first place: how the county awarded millions in contracts to a nonprofit whose top financial executive has been charged with embezzling hundreds of thousands of dollars.
In February, the San Diego County District Attorney’s Office charged Amy Knox, the former chief financial officer for the Harm Reduction Coalition, of stealing from her nonprofit and using the money to finance cosmetic surgeries, vacations and other personal expenses. Knox pleaded not guilty in April.
Amid the fallout, county officials defended their contracting practices but still ordered an outside review.
In recent years, the Harm Reduction Coalition had won more than $12 million in county contracts to distribute drug-testing kits and naloxone in a bid to prevent opioid deaths. But public records reviewed earlier this year by The San Diego Union-Tribune found that multiple red flags did not stop the county from doing business with the nonprofit.
For one, Knox had previously been convicted of embezzling hundreds of thousands of dollars from a previous employer about a decade ago.
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When the county inked the contracts with the Harm Reduction Coalition, the nonprofit was not even licensed to do business in California and had not filed any public tax returns.
According to Voice of San Diego, a whistleblower tipped off the county about Knox’s criminal history in 2023. The report triggered an audit, though the county continued to contract with and pay the nonprofit before terminating the agreements in 2025, Voice of San Diego reported.
Although the new review was ordered in response to the Knox case, it makes no mention of her or the Harm Reduction Coalition.
But it does offer dozens of suggestions for how to reform countywide contracting practices — along with four recommendations for the Health and Human Services Agency, the largest division of county government and the one that first hired the Harm Reduction Coalition.
According to the review, HHSA needs to standardize how it conducts site visits to contractors. The agency also makes frequent changes to its workflows and processes for monitoring contracts, a practice that the review says needs to be minimized so as to avoid confusing staff about their responsibilities.
“HHSA has a defined monitoring framework with documented policies, standardized tools and established expectations,” the review said.
The county has so far spent $44,000 on the review, which was performed by public accounting firm Eide Bailly, said county spokesperson Tammy Glenn. She declined to say whether the county were still conducting any other review of its dealings with the Harm Reduction Coalition.
“The County is evaluating the recommendations in the auditor’s assessment to determine the next steps needed to strengthen contracting practices and protect public resources and will continue to take all opportunities to identify improvements,” Glenn said.
“We will also continue to cooperate with the District Attorney’s active investigation,” she added.
The review comes as two members of the Board of Supervisors have launched their own effort to investigate county contracting practices.
In November, Democrat Paloma Aguirre and Republican Joel Anderson formed a subcommittee aimed at studying how county contracting could be reformed to save the county money.
So far, the panel has met only twice. According to its agendas, the meetings have been largely informational, with presentations from county contracting and economic development officials. Its next meeting is set for August.
In a statement, Aguirre called the new report a “serious first step.”
“Taxpayers should never have to wonder if someone is watching their money,” Aguirre said. “The report says the county does a good job choosing who gets a contract. The challenges come after the contract is signed, in how the county tracks the work and the money. That is where we need to improve.”
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Anderson did not respond to a request for comment.
