County Predicts Health Crisis, Asks State to Restore $10.5-Million Cut

Acting to avert a prospective health “catastrophe,” San Diego County lawmakers Wednesday called on state legislators to attempt to restore $10.5 million in local funding slashed from a program designed to provide care for poor adults.

“We now know exactly how catastrophic these cuts will be to San Diego’s working poor,” said San Diego supervisor Leon Williams, who said the reductions would prevent many low-income people from receiving any kind of preventive care, creating a health “crisis.”

Attending a briefing on the topic at the county administration building were representatives of each member of the San Diego legislative delegation in Sacramento, all of whom vowed to study the issue and attempt to do what they could. But there were no assurances of additional aid to bridge the funding gap, either via administrative or legislative action.

The problem is actually a statewide one, and counties throughout California are bracing for funding shortfalls in the program in September, when the budget crunch is first expected to be felt. Statewide, the Administration of Gov. George Deukmejian has slashed more than $100 million from the health program, including the $10.5 million from San Diego-area expenditures.

The cuts are in the County Medical Services Program. The program provides state funds to pay for emergency and urgent health-care costs for poor adults. The effort is considered a key means of providing health care to so-called “indigent” people who are uninsured and unable to meet the skyrocketing costs of doctors, hospitals and other health providers.

Nationwide, the price tag of indigent health care is considered a critical public concern, costing taxpayers, hospitals and other health providers hundreds of millions of dollars annually.

The affected state program, said Sandra McChesney, who oversees the effort in San Diego for the county, “is the health safety net of the county.”

Potentially eligible for the program’s assistance, officials say, are up to 400,000 legal U.S. residents between the ages of 21 and 64 in San Diego County. (Care for indigent undocumented people is paid through other programs.) Those served by the indigent-care program must demonstrate financial need and cannot be eligible for Medi-Cal, the huge state and federally funded health-care system, and must have no other source of health-care payments.

Provided Care for About 25,000

Each year, county officials say, the now-threatened program pays for the care of about 25,000 people, mostly single adults and couples without children, who may be treated at more than 2 dozen hospitals and clinics. County officials use the state funds to reimburse hospitals and other health-care providers. San Diego health planners expected to receive about $41 million for the program in the 1989-90 fiscal year. Instead, the state has announced that only about $30.5 million will probably be provided, a cut of more than 25%.

Reacting to fierce criticism of the cutbacks, Deukmejian Administration officials have maintained that the slashed funds will probably be made up from other sources, notably a federal program to offset the medical costs of foreigners newly legalized under the government’s amnesty effort. But local authorities have disputed that contention, asserting that only a minority of those served by the health program are amnesty recipients.

“I can’t keep this program together with any substantial cut,” said Dr. J. William Cox, the county health services director, who characterized the effects of the reductions as a “catastrophe.”

If the cuts are not reversed, Cox said, he will be forced to slash a wide variety of health services now funded by the program, including mental health treatment and care for many disabling and life-threatening illnesses. He called the cuts the “death knell” for the program, which he said had been in effect since 1983 and underfunded even before the latest threat.