$1.6-Million Fund Goes Untapped by Doctors : Health: Few county physicians use the state program, which was created to encourage health-care providers to treat more pregnant women and poor children.

Much of the $1.6 million in tobacco taxes set aside to reimburse Ventura County doctors who treat indigent patients has gone unclaimed and may have to be returned to the state, county officials said this week.

Few local doctors have enlisted in a special state program designed to encourage physicians to treat more pregnant women and poor children, the officials said. The program also pays them for treating indigents in hospital emergency rooms.

“I don’t think the physicians locally are interested in it,” said Phillipp K. Wessels, director of the county’s Health Care Agency. “The procedures to get the money are very cumbersome. And I don’t see any significant trends that indicate we’ll spend all this money.”

If unspent, the money must be returned to the state for redistribution, but none will be lost until next year, Wessels said.

Of the $1.6 million Ventura County has received since the program began in February, doctors had claimed only $152,000 as of Friday, the county reported.

A similar situation apparently exists in counties throughout California, said state officials and a spokesman for the California Medical Assn.

“I’m hearing the same thing. Claims are not coming in,” said Michael Kassis, chief of the Medically Indigent Section of the state Department of Health Services.

Kassis said distribution of the so-called Physician Services funds--collected as part of a 25-cent-a-pack tobacco tax passed in 1988--has been slow because doctors do not know much about it.

Of the $578 million expected to be collected from new tobacco taxes for the 1990-91 fiscal year, about $58 million will be forwarded to Physician Services accounts overseen by the counties, he said.

George Cate, associate director of the California Medical Assn., predicted that as word spreads about the program, more doctors will file claims and open their doors to increasing numbers of poor patients because the state guarantees that they will be paid for treatment.

Under the Physician Services program, doctors seeing patients who cannot pay their bills and who are not covered by Medi-Cal will be reimbursed for 50% of their billing--about the same amount allowed under Medi-Cal, officials said.

Ventura County officials said ignorance of the program is also apparently the biggest obstacle locally.

“It’s a great program,” said Andrea Pendleton, operations director for the Ventura County Foundation for Medical Care, a private firm that processes claims for the county. “But we think we’ve had some misconception in the physicians’ offices. They don’t understand that they can recoup this money. It’s just a continuing education.”

Seminars about the program have been held at six of the seven private hospitals in the county and another is scheduled next week at Los Robles Regional Medical Center in Thousand Oaks, said Kathy Chester, program administrator at the Health Care Agency.

“Immediately after each seminar, we’ve had an influx of claims,” she said. Since payment of local claims began in May, the amounts distributed countywide have increased from $11,000 to about $33,000 in November, officials said.

The claims, though increasing, are still only a fraction of those needed to meet the goals of the program, Chester said.

The county, in conjunction with the 600-doctor county Medical Society, is working with the hospitals to try to enlist more emergency room physicians, obstetricians and pediatricians into the program, Chester said.

Yet, Chester said, doctors and their staffs have seemed daunted by the paperwork. Background information required by doctors includes details such as whether patients are newly legalized immigrants, she said.

At a Thousand Oaks pediatric clinic, which receives numerous patients who cannot pay their bills, office manager Vicki Goldschlager said she has not filed claims for reimbursement because she thought that the program only covered emergency treatment.

But doctors who treat expectant mothers and children can also be reimbursed for non-emergency care, Chester said.

County officials say they hope that area physicians are informed before next November, when money from the 1989-90 fiscal year must be returned to the state if not spent.

In fact, state law requires that funds from fiscal 1989-90, which ended June 30, be returned to the state by the end of this year if not committed to pay claims. But declarations by Ventura County that it expects to spend the money will keep it in county coffers for another 12 months.

Proposition 99, the tobacco-tax initiative approved by voters in November, 1988, increased the tax on cigarettes from 10 cents to 35 cents a pack.

Laws to determine how the money would be split up and administered were not passed until October, 1989, and tax money did not begin to reach the counties until February.

About 10% of the tobacco taxes go to the physicians’ account and 35% to hospitals. Another 20% is earmarked for health education, 5% for research and 5% for public resources such as parks. A final 25% can be distributed as the counties want among all the classifications.