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Suit Charges Illegal Delays in Processing Medi-Cal Applications : Health: The 45-day deadline is often violated, two public-interest law groups say. They allege dire health consequences.

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TIMES STAFF WRITER

Alleging that pregnant women and newborn children are waiting as long as 14 months for their Medi-Cal applications to be processed, two public-interest law firms filed a class-action lawsuit in federal court Wednesday against Los Angeles County and the state Department of Health Services.

As a result of the delays, many poor women in Los Angeles County are going without prenatal care and are giving birth to sickly, underweight babies, the suit alleges. Once born, many children are going without immunizations and other medical care, it says.

Federal law requires applications to be processed in 45 days. In March, however, 17,000 Medi-Cal applications filed at county offices had been pending for 60 days or longer, according to statistics compiled by legal-aid attorneys from county records.

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“When pregnant women apply for Medi-Cal to cover their prenatal care and still have not received a decision on their application by the time their newborn babies are 6 months old, there’s something seriously wrong with the system,” said Byron Gross, an attorney for the Legal Aid Foundation of Los Angeles, which filed the suit along with the Western Center on Law and Poverty.

Attorneys with the two law firms said they will seek a preliminary injunction requiring the county to process applications within the statutory 45 days. Listed as the defendants in the suit are the county Board of Supervisors, the directors of the county Department of Public Social Services and the county Department of Health Services.

Carol Matsui, a spokeswoman for the Department of Public Social Services, declined to comment, saying the department had not yet been served with the suit.

But Steve Carnevale, principal deputy county counsel, disputed the figures cited by the attorneys. He said 87% of the approximately 21,000 Medi-Cal applications handled by the county in March were processed on time.

Carnevale added that in most cases a delay past the 45-day waiting period has “a minimal effect on the client. Whether or not they’re eligible for Medi-Cal doesn’t mean they won’t get medical care. They can get free medical care at a county facility.”

But Lynn Kersey of the Los Angeles Homeless Health Care Project said that if economically disadvantaged patients are denied Medi-Cal, the quality of health care they receive declines dramatically.

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Faced with county health workers who tell them that they will be billed for the services, many pregnant women decide to put off preventive, prenatal health care, Kersey said.

She added that without Medi-Cal many of her clients are unable to afford prescribed medicines such as ear drops to treat their infants’ infections and vitamins needed during pregnancy.

Four children and their parents are named in the suit as plaintiffs. Edith Estrada, 31, has been denied her Medi-Cal eligibility since last November, even though she met all the program’s eligibility requirements, the suit alleges.

The complaint said that as a result, Estrada was unable to receive prenatal care during the last three months of her pregnancy. Her daughter, Rubi Garcia, was born in January underweight and is classified by doctors as “high-risk.” Still, the 7-month-old baby and her mother have yet to receive their Medi-Cal eligibility, the suit says.

Los Angeles-area attorneys who work with the poor said they began to notice a dramatic increase in Medi-Cal processing delays about a year ago when Medi-Cal rules were changed to make more people eligible for the program.

Gross said he and other public-interest attorneys had been meeting with county health officials to discuss the delays for the last few months. When the talks failed to correct the situation, he said, the attorneys moved to file the lawsuit.

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Gross said a hiring freeze--lifted earlier this year--at the Department of Public Social Services may be partly to blame for the delays. He cited a department study that showed the number of pending Medi-Cal applications had increased from 7,451 in January, 1988, to 21,806 in December, 1989.

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