Board Challenged on Indigent Care Cuts : Medicine: Hospital leaders threaten to sue unless supervisors hold a hearing and say why they won’t provide more money for health services.

Saying Orange County has a legal obligation to provide health care to the poor, hospital leaders Thursday demanded that the Board of Supervisors hold hearings on budget cuts in indigent care or face a lawsuit.

“Orange County’s supervisors are going to have to face up to their legal responsibility one way or the other--either provide health services for poor people or tell the voters why they won’t,” said David Langness, vice president of the Hospital Council of Southern California.

Late Thursday county lawyers were studying a written request from the hospital council’s attorney for formal hearings. Such hearings, known as Bielenson hearings, are triggered when a county plans to reduce medical services. The supervisors will respond by the hospital council’s Jan. 18 deadline, Deputy County Counsel Thomas Morse said.

But other county officials said they do not believe there is justification for such hearings.

Although local hospitals are grappling with an $11.4-million reduction in reimbursements in the county-run Indigent Medical Services program, “there have been no service reductions,” said Ronald Diluigi, assistant director of the County Health Care Agency. “Bielenson covers reductions in service, not reductions in budgets.”

The county’s medical services director, Herbert Rosenzweig, agreed. “We--the county--are not cutting services,” he said.

Although reimbursements for indigent care were reduced almost by half for the 1990-91 fiscal year, so far none of the 29 hospitals with Indigent Medical Services contracts have quit the program, Rosenzweig noted. About 24,000 county residents--mostly the working poor--are covered by the program and they are receiving medical services this year as usual, county officials said.

But hospital leaders argued Thursday--as they have for the last six months--that such a steep budget cut will eventually force hospitals to quit the Indigent Medical Services program.

Hospitals that were being paid 20 cents on the dollar for IMS patients now get only 10 cents on the dollar--and they can no longer absorb these costs, said hospital council Vice President S. Russell Inglish.

J. Robert Liset, attorney for the hospital council, said the Bielenson hearings would force the Board of Supervisors to explain its budget priorities and declare whether the cuts in funds will have an adverse affect on the poor. Depending on the supervisors’ findings at the hearings, the hospital council may file a lawsuit “to force the funding” in full of the indigent services program, Liset added.

Strongly backing hospital officials at Thursday’s press conference in Santa Ana were leaders from the League of Women Voters, the United Way Health Care Task Force, the Orange County Medical Assn. and a health education group, California Health Decisions.

The current dispute between health care leaders and the county stems from last summer’s budget decisions. In late July, Gov. George Deukmejian sharply cut funds to every county that paid for indigent medical services.