Trauma Centers Backed for Tobacco Taxes

Orange County health care officials on Monday proposed using $8 million in available state cigarette surtax money to help stabilize the county’s ailing trauma care system while creating two new birthing centers for low-income women.

The county is scheduled to receive about $22 million a year for two years from a surtax levied on cigarette and other tobacco products under Proposition 99, the statewide initiative approved by voters in 1988.

In the spending plan, which is expected to be presented to the Board of Supervisors on March 6, Tom Uram, director of the county Health Care Agency, suggested that a total of $5.7 million be directed to the existing three trauma centers in the county and a possible fourth facility in northern Orange County.

“This money will certainly help stabilize the trauma center system,” said Herbert Rosenzweig, director of the county’s medical services. “It certainly is a comprehensive plan.”

The revenue will enable Orange County health care providers to improve services for low-income patients and in many cases pay providers more for services rendered, the report to the supervisors said.

“However, it must be emphasized that this new revenue does not solve the major health care problem that exists at the federal, state and local level,” the report said.

The birthing centers, slated for UCI Medical Center in Orange and Western Medical Center-Anaheim, would receive $2.3 million under the plan, which must be approved by county supervisors and then sent back to the state for final approval.

The number of birthing centers nationwide is increasing. The one planned for UCI Medical Center is a 14-bed facility staffed by nurse-midwives that could handle up to 1,700 births the first year. County health officials estimate that the two birth centers could handle as many as 2,000 deliveries a year the first year. That would go a long way toward relieving severe overcrowding in the maternity wards of hospitals treating low-income women, officials said.

Because medical center officials expect that nearly all birthing center patients will be indigent, they are seeking state tobacco tax funds to enable them to make capital improvements and open by 1991.

Medical center officials also are negotiating with Medi-Cal for a favorable reimbursement rate. Presently, it is estimated that a one-day birth center delivery would cost $970, compared to $1,200 for a typical two-day hospital delivery.

The $1.3 million recommended for Western Medical Center would be used to build and operate 20 labor and delivery rooms targeted for low-income women.

Orange County’s four trauma centers were reduced to three late last year with the closing of the Fountain Valley Regional Hospital and Medical Center’s facility. Fountain Valley closed its center because of the skyrocketing cost of treating indigent patients and maintaining malpractice insurance. The closure had a profound effect on the three remaining trauma centers in the county: UCI Medical Center in Orange, Mission Hospital Regional Medical Center in Mission Viejo, and Western Medical Center-Santa Ana.

“We have been working very diligently for several months and we are very pleased with the package we are sending to the Board of Supervisors,” Uram said.

Assistant Health Agency Director Ronald R. Diluigi has been meeting for nearly three months with hospital officials, doctors and those who operate clinics that treat the poor.

Uram said the program would also set aside money to improve networking between hospitals, doctors and clinics, which will result in a better overall health care system for the poor.