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Indigents' Health Care Gets a Boost

Medicine: County to increase the program's annual budget to $47 million. Advocates say the system is still badly underfunded.


The Orange County Board of Supervisors on Tuesday approved a plan to reorganize medical care for the uninsured poor and agreed to provide an additional $2 million for increased pharmacy costs.

Supervisors voted 4 to 0 to revise the Medical Services for Indigent program. Supervisor Jim Silva was absent.

Plans to revise the county's indigent care program got a major push in August, when UCI Medical Center officials announced they no longer would take new patients who lived more than five miles from the hospital in Orange or two miles from its satellite clinics in Anaheim and Santa Ana.

UC Irvine officials said they could not continue to treat the largest share of the county's uninsured and that 24 other hospitals contracting with the county needed to take more of the patients.

The county reimburses only a portion of the costs for treating indigent patients.

The plan approved Tuesday increases to $47 million the amount the county spends annually on the indigent care program. It also adds many elements of managed care, including a case management system to refer patients for appropriate care, whether to specialists or skilled nursing facilities.

The county also is negotiating with several hospitals to take transfers from UCI and help equalize the patient load.

But health-care advocates told supervisors the changes still don't address the most important problem with the system: that it is badly underfunded. Orange County is one of three counties in the state without a county-run hospital.

John Gilwee, vice president of the Hospital Assn. of Southern California, which represents Orange County's acute care hospitals, told supervisors that the county reimburses a hospital $167.10 for a $1,000 stent that is commonly used in heart surgery. That doesn't include the costs for the doctor, other skilled staff and equipment, he told them.

Supervisors also voted to transfer $7.2 million from the county's share of national tobacco settlement funds to the Coalition of Orange County Community Clinics. The organization will distribute the money to its members to increase patient access to its clinics.

Some clinics are expected to build exam rooms or buy mobile health-care units, coalition executive officer Marty Earlabaugh-Gordon said.

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