Babies-Only Pacts Asked by Hospitals : Health care: O.C. medical leaders urge state commission to let them take only maternity patients. The panel is questioning their motive.

Saying that some maternity wards serving the poor are so packed that women are having babies in the halls, Orange County medical leaders urged skeptical state commissioners to ease the crowding by awarding more contracts that would let hospitals limit their Medi-Cal patients to expectant mothers.

Members of the California Medical Assistance Commission, the state body that negotiates contracts for indigent care, took no public action Thursday. But before they went into closed session, several members criticized the idea.

“Why is it that you want obstetrics only?” demanded Commissioner Eric Gold. “Is that another way of saying you’d like to be able to say ‘no’ to all the med-surge (medical and surgical) patients?”

Hospital officials are reluctant to take Medi-Cal patients because the state pays less than the actual cost of care.

Gold and Commissioner Louis Papan suggested that granting contracts limited to obstetrics might persuade other hospitals to drop full-service Medi-Cal contracts for the poor. Argued Gold: “If this commission started going obstetrics-only as a matter of course, wouldn’t it begin the unraveling of the rest of the (Medi-Cal) system?”

But hospital leaders and several doctors said no. Rather, they argued, this was a short-term solution to overcrowding in the maternity wards at the nine hospitals in Orange County that have Medi-Cal contracts.

“We have adequate medical-surgical capacity (in the county). We do not have adequate obstetrical capacity,” said John Cochran III, executive director of La Palma Inter-Community Hospital, a Medi-Cal contractor that experienced a 25% rise in births last year. “Right now we have mothers who have nowhere to deliver their babies.”

Meanwhile, Mary Piccione, director of UC Irvine Medical Center in Orange, testified that the county’s Medi-Cal network was already gone.

When UCI signed a new Medi-Cal contract last year, commissioners had promised that more hospitals would join the system, but they have not, Piccione said. Instead, she testified, “The Medi-Cal network has not been restored and UCI continues to serve 50% of Orange county’s Medi-Cal population.”

Asked later if UCI might drop its Medi-Cal contract later this year, Piccione said curtly, “It’s a possibility.”

Last year, UCI officials threatened to quit the Medi-Cal system, saying they were losing millions of dollars on indigent care and that such care was interfering with the teaching mission of their hospital.

Recently, in a complaint to the state Health Department, the hospital was accused of discriminating against the poor by delaying their elective surgeries but going ahead with surgeries on paying patients.

State health officials Thursday said they were still investigating the complaint. And Piccione said that surgeries for both privately insured and indigent patients were delayed. “The problem is we’re saturated” with patients, she said.

On Thursday, officials from community clinics, the Orange County Medical Assn., the Hospital Council of Southern California, March of Dimes and United Way asked commissioners to sign more hospitals in the county to full-service and obstetrics-only Medi-Cal contracts. (The only obstetrics-only contract in the state is with AMI Medical Center of Garden Grove, but that is to expire later this year.)