Medical Care for 12,000 Children With Catastrophic Illness in Peril

A Los Angeles County health official has warned that unless the state provides an emergency infusion of $4.5 million by March 31, he will no longer authorize medical services to about 12,000 children with catastrophic illnesses and handicaps.

Frank L. Rico, county director of the California Children’s Services program, issued the warning in a letter to Maridee A. Gregory, chief of the Children’s Services branch of the state Department of Health Services.

In an interview on Wednesday, Gregory noted that state government is in a severe budget crunch and that she is seeking relief money for the Los Angeles program, but “I can’t make an absolute commitment until I can be sure I have the funds.”

The children’s medical program, financed 75% by the state and 25% by California counties, provides diagnostic and treatment services for about 90,000 youngsters statewide who suffer life-threatening illnesses or major handicaps, ranging from heart surgeries to cerebral palsy.

About 40% of the caseload are low-income children receiving Medi-Cal aid, while the remainder are usually from middle-class families whose adjusted gross income is less than $40,000 a year. Medi-Cal children would not be affected by the threatened cutoff of medical services.

In Los Angeles County, the program serves 30,000 children, about 12,000 of whom are not Medi-Cal patients. Rico blamed the shortage of funds basically on unanticipated caseload increases.

Rico sent a letter last Friday to about 5,000 physicians, hospitals and other health care providers, noting that they had not been paid for services for about three weeks and assuring them payments would resume “as soon as the state approves the additional funds requested.”

In a follow-up letter to Gregory on Monday, Rico asked for confirmation of approval of the money. “If this confirmation is not received by Friday, March 31, 1989, we will stop issuing medical authorizations for services,” he said.

Sources in the Department of Health Services said this meant that approvals for diagnostic and other medical services would cease for about 12,000 children in Los Angeles County. “If you are not authorizing services, you are not providing benefits,” one said.

Rico on Wednesday said in an interview that, despite his warning letter, if the state funds failed to materialize the Los Angeles program would not be “out of business.” He added, “There is always some room for negotiations. (But) We need a fairly quick response.”

“We are making efforts as rapidly as we can to assess the budget to see if there are going to be funds available and attain additional funding, if necessary,” Gregory told The Times. “Past history has shown that California Children’s Services has always come up with the funds that are necessary to meet the needs.”

Gregory said several options were under consideration, but refused to discuss whether the Deukmejian Administration would seek an emergency appropriation from the Legislature as it did recently when regional centers for the mentally retarded were threatened with closure due to lack of funds.

A physician, Gregory said each year some counties seek emergency state aid and others do not. “Some counties spend more than they originally thought and some spend less,” she said.

Times staff writer Lois Timnick contributed to this story.