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Health Care Issues Spur the Public to Speak Out

September 27, 1987|DENNIS McLELLAN | Times Staff Writer

They participated in a coalition that successfully lobbied to have the county health services budget provide prenatal care for 500 more women a year.

They have conducted workshops on how to fill out the durable power of attorney for health care, a legally binding document that ensures a patient's treatment wishes will be followed if he is incapable of deciding himself.

They have held educational forums on how other countries deliver health care, and they're preparing a new series of countywide small group meetings that will focus on acquired immune deficiency syndrome.

When California Health Decisions-Orange County Project started two years ago, its goal was to seek public opinion--and recommendations--on the many difficult health-care issues that have emerged in reaction to life-prolonging medical technology and increasingly high medical costs.

The people have spoken: nearly 5,000 of them in a series of 12 town hall meetings and more than 200 small group meetings held throughout Orange County in eight months.

Study Implementation

And, since February, volunteer task force members have been working on finding creative ways to implement the public's health-care recommendations.

"The task forces are very action oriented," said Ellen Severoni, executive director of California Health Decisions. "They are the vehicles for taking the information we got from the small groups and from the subsequent (health care) parliament, and (for) getting that out to policy makers and health-care providers and other people in power who need that input in order to make decisions that reflect the community's values."

The lack of a community forum for discussing health-care issues provided the spark that generated the ambitious grass-roots project in 1985.

Modeled after a pioneer project conducted in Oregon in 1983-84, California Health Decisions-Orange County Project is the first such effort to be undertaken in California. It is one of 13 statewide projects seeking public opinion on health-care issues.

The Orange County Project, initially co-sponsored by the now-defunct Orange County Health Planning Council and the Center for Bioethics at St. Joseph Health System in Orange, is funded primarily through grants from the Prudential Foundation and the James Irvine Foundation.

The project allowed ordinary citizens a chance to voice their opinions on such difficult ethical questions as: Does everyone have the right to health care, whether they can afford it or not? Should life-prolonging technology be used in every case? What areas of health care should have priority in the allocation of tax dollars?

In February, four volunteer task forces of 15-20 members each were formed to find ways to implement the public's top health-care recommendations, which had been voted on during the project's daylong Health Care Parliament last fall.

First Summit Slated

On Wednesday, the Orange County Project will hold its first task force summit to discuss the group's accomplishments and plan future activities. The summit meeting will be held from 6 to 8:30 p.m. at Loyola Marymount University, 480 S. Batavia, Orange. The public is invited.

Severoni, who is overseeing similar projects now under way in West Los Angeles, Sacramento County and the northern San Francisco Bay Area, views the Orange County Project as being open ended.

"What's happening," she said, "is the community is learning how to use the process to identify health-care needs, to focus in on their particular health-care concerns and to bring about change. As long as they need us as a vehicle for doing that, we'll be here."

In an office donated by St. Joseph Health System, Severoni, who supervises a California Health Decisions staff of three, provided an update on task force activities and a look at the the Orange County project's upcoming events.

Volunteers are being sought to serve as leaders for the upcoming series of small group meetings on AIDS. For information about training sessions, call (714) 647-4920.

The new round of small group meetings, which begin Oct. 21, will be held in two parts. The first meeting will be primarily educational, with trained leaders using a discussion guide prepared by county AIDS experts. The second meeting will cover broader policy issues such as AIDS testing, alternative AIDS treatment centers and how the public wants its health-care dollars allocated.

"In the California Health Decisions spirit," Severoni said, "citizens will be able to offer their opinions on these issues. Their recommendations will then be passed on to the appropriate people: legislators, hospital administrators and physicians."

The Primary Role

That has been the primary role of the task forces since they began meeting seven months ago. Severoni said the volunteer members were divided into groups representing four broad categories:

- Access to Health Care:

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