Hospital Turn-Away Plan Irks Legislators

Several Orange County legislators complained Wednesday that UCI Medical Center had failed to notify them of a new policy to turn away women in labor whenever its emergency room and obstetrics ward are full.

Had they learned of the university hospital’s “drastic” plans, they might have sought emergency funding or asked other hospitals and county officials to seek a solution for overcrowding of the obstetrics ward, the legislators said.

But, they said, no UCI official called them and they only learned about the new policy after the fact, from newspaper accounts.

“I think it is unfortunate. I would like to have been able to use whatever efforts I could to help the situation,” said state Sen. Marian Bergeson (R-Newport Beach), a member of the Appropriations Committee who often sponsors health care legislation. Instead, she said, “we have not had communications this year” about such a plan.

Bergeson also expressed alarm and dismay about the policy itself, which the medical center began implementing Friday.

When the hospital is full, the “obstetrical diversion” plan takes effect: The facility’s security guards will greet a woman in labor at the curb, telling her to go elsewhere and handing her a map and a list of area hospitals. But women who have had prenatal care at UCI Medical Center will be given priority during an announced “deflection,” hospital officials have said.

In a letter Friday explaining the new policy, hospital officials said that obstetrical services are strained and sometimes “unsafe” and that doctors are treating 500 patients a month in a ward designed for 250. Reportedly 90% of the women in labor at the medical center are indigent and most have received no prenatal care.

Bergeson on Wednesday called the new policy “irresponsible.”

“You cannot send a woman in labor out onto the street without assurance that she’s going to have an effective delivery,” the senator said. “I would say it’s irresponsible from the health and safety (standpoint) of that woman.”

Also concerned about the hospital’s actions was Assemblywoman Doris Allen (R-Cypress), who sits on the Assembly Health Committee.

Allen said UCI Medical Center officials had kept her informed of the financial problems, including the fact that the hospital is rapidly going bankrupt treating 65% of the county’s poor. Noting that she is sympathetic to their problems, Allen said she has been working to increase the medical center’s reimbursement rate from the state Medi-Cal system.

But, the assemblywoman said, aside from newspaper accounts in the last few days, she has heard nothing about the medical center’s crisis in obstetrics.

“I would wish they had called to see if there’s something they could do before taking this drastic measure” and deciding to turn women in labor away, Allen said late Wednesday.

Asked whether she could have helped, Allen replied: “Well, I certainly could have tried. I could have talked to other hospitals in the county to see if there was something we could do short of putting those patients in jeopardy.”

Allen said she does not know whether UCI Medical Center officials asked county officials for help before implementing the plan. But if the medical center officials “have not worked with other hospitals in the county, yes, I would fault them,” she said. “If they are overcrowded, they should get on the phone--and not send security guards” to turn away pregnant women.

State Sen. Cecil N. Green (D-Norwalk) said he learned of the new policy from a newspaper account and wondered why he had not been contacted by UCI.

Hospital Criticized

Green said he planned to write a letter to UCI “asking what I can do to help the situation,” but he criticized the university hospital for its new policy.

The hospital, he said, has “a moral obligation to take care of the indigent.” Also, Green said, “any doctor practicing has sworn a Hippocratic oath. If they’re not taking care of the sick, they’re not keeping up with their oath.”

State Sen. John Seymour (R-Anaheim) also said he thinks the medical center has a responsibility not to turn away any woman in labor.

“Quite frankly, when I learned of this policy, I was rather shocked,” Seymour said. He added that although he is not a lawyer, he believes that it is illegal and “the wrong way to go.”

Seymour said he met with UCI Chancellor Jack W. Peltason and UCI Medical Center executive director Mary A. Piccione several months ago about working to improve the reimbursement rate for Medi-Cal services, but they did not mention the crisis in obstetrics or a strategy to turn some of those patients away.

“I just think it’s wrong that a state-supported institution is supporting this policy,” Seymour said. He said officials knew years ago when they purchased the old County of Orange public hospital for their medical center that care for the poor “would be one of their primary responsibilities. . . . Ultimately it’s the public’s responsibility to care for the poor and this is a public institution.”

Burden of Caring for Poor

Piccione and Walter Henry, UCI vice chancellor for health services, who supervises the medical center, could not be reached for comment Wednesday. But they have previously said that the medical center’s primary purpose is teaching and research, not shouldering the burden of caring for most of Orange County’s poor patients.

Also interested in the “obstetrical diversion” policy was Orange County Supervisor Don R. Roth, whose district includes the medical center. Roth said he doubts that the county can help.

“The problem is we have a hiring freeze here, we’re closing facilities. We’re broke. . . . I can’t do anything for UCI until I have some money. If somebody sends me some money, I’ll run over this afternoon,” Roth said.