County Medical Assn. Seeks to Solve Hospital Turn-Away Crisis

Decrying the crisis over medical care for the poor, the Orange County Medical Assn. announced Friday that it will hold special meetings to try to solve the immediate problem of women in labor being turned away from overcrowded UCI Medical Center.

“This is not a UCI problem. It is more than the poor obstetrical patients. This is a very real demonstration of the failure of the state government to be responsible for the care of the people in this state,” association President Dr. Russell C. Ewing II said in a prepared statement.

“This is not a time to point fingers or to express astonishment at UCI’s actions. The dam is broken. There is no place to run. We are all affected. The well-being, the very health of people, is at stake, and we must respond.”

The prepared statement said Ewing and the president of the county’s society of obstetricians and gynecologists have called a special meeting with “professional representatives to address stemming the immediate problem.” Afterward, the Orange County Medical Assn. will meet with county and state officials. “Accountability will be demanded,” the statement said.

Ewing and other association officials could not be reached for comment.

In a related development, a UCI Medical Center spokeswoman said Friday that Medi-Cal officials have rejected a plan to divert some of the overflow patients. UCI had asked to subcontract with AMI Medical Center of Garden Grove to handle up to 100 “low-risk deliveries” a month. The AMI hospital does not hold a contract with Medi-Cal to be reimbursed for treating indigent patients. UCI spokeswoman Susan Meister said hospital officials were notified of the decision Thursday afternoon.

Michael Murray, executive director of the California Medical Assistance Program, which negotiates Medi-Cal contracts with hospitals for the state, said that request was turned down because the arrangement “was not in the best interest of the contracting program.”

He said UCI was asking to send patients to another hospital and yet collect more from Medi-Cal than UCI would pay the AMI hospital--in effect, making a profit.

“Some would say that’s selling medical patients,” Murray said. “There are other means to solve the problem, and this would not solve it anyway.”

Murray said the arrangement was for the AMI hospital to handle only low-risk births, but since UCI handles so many patients with no prenatal care--making them susceptible to complications--there was “no guarantee” that the patients involved would not be high-risk. Further, he said, the proposed arrangement would have sent an average of four patients a day to the Garden Grove hospital, when UCI has had up to eight more obstetrical patients a day than it is licensed for. “So this is not a solution in and of itself,” he said.

But UCI’s Meister countered that “any help would be welcome.”

If the Garden Grove hospital could take four patients a day, “that’s all that’s needed to get us out of a crisis. We’re still willing to do more than our share, but we can’t operate at this level with our staff and our space without creating a safety problem,” Meister said.

She said the agreement with the AMI hospital would have allowed the Garden Grove facility to transfer any high-risk patients to UCI. Further, Meister questioned Murray’s contention that UCI would profit financially.

She said UCI officials were told the commission turned down the subcontracting arrangement only because the agency did not want to set a precedent.

“Is it more important to get this taken care of than to haggle over Medi-Cal rates? The key was to get people taken care of,” Meister said. “It’s a setback that only aggravates the situation, which is grave.”