County to Sue State Over Medical Funding : Public Health: Action by supervisors comes following termination of CMS program, which provided care to the working poor.

San Diego County supervisors decided Wednesday to sue the state over its failure to fully fund medical care for the working poor.

The suit will be a cross-claim to a similar suit filed against the county Monday by patients, and is expected to be filed today.

As a result of the supervisors’ decision, lawyers agreed to delay until 4 p.m. Monday a Superior Court judge’s consideration of whether to temporarily stop the closure of the County Medical Services program.

Judge Harrison Hollywood will be considering the court-ordered halt, requested by the Legal Aid Society of San Diego, just one day before the CMS program is scheduled to terminate.

Legal Aid lawyers agreed to delay consideration of their case until Monday so Hollywood could deal with both that case and the county’s suit against the state.

From a legal standpoint, the agreement speeds up the path toward an injunction to bar the CMS closure while the suits are being resolved, said Carol Ratsamy Bracy, a Legal Aid lawyer. Normally, it would take about two weeks before that hearing would be held.

“In a way, we can look at that as a victory because we’re going to be able to ask for the preliminary injunction earlier than we would have been able to,” Bracy said.

However, for anxious patients who had hoped for an interim order from the judge Wednesday, it meant more days of anxiety, she said.

“A lot of them were hoping that on Wednesday somehow there would be this miracle, and they would get CMS continued by the judge,” Bracy said. “We’re talking about a matter that is so urgent and is so central a focus for these people that this is basically their whole lives being on hold for another few days.”

County supervisors decided last week to terminate the CMS program March 19. The program gives life-sustaining care to the working poor and other ill adults who have low incomes and no health insurance. Supervisors blamed a cutback in state funding from $41 million last fiscal year to $19 million this year.

But the 17,000 current clients of CMS--many of whom cannot afford even discounted medical care--will be left with no good options. Hospital administrators expect many to wind up seriously ill in emergency rooms. The crisis is also expected to magnify the effect of the closure of another hospital that served the poor, San Diego General.

Indeed, a hospital traditionally known for caring for the poor, UCSD Medical Center, already has seen a marked increase in emergency room use, said spokeswoman Leslie Franz.

The emergency room at the Hillcrest facility was shut to ambulance traffic 28 times in February, contrasted with nine times in February 1990, she said.

The shutdowns were for varying periods, as the number of walk-in emergency patients soared as high as 160 a day. It averaged 140 for the month. Previously, the emergency room averaged about 120 patients a day, Franz said.

Supervisors’ Chairman John MacDonald said the decision to sue the state was made because Sacramento has refused to budge on the issue of who is responsible for caring for the medically indigent--the county or the state.

The Legal Aid suit says it is a county responsibility. The state says it is a county responsibility. But San Diego County officials disagree.

“We have a difference of opinion, and we want to find out what the courts say about that,” MacDonald said. “We feel very strongly that it’s a state-mandated program and they have an obligation to supply the money to run it.”

The vote on the suit in a closed session was unanimous, with Supervisor Brian Bilbray absent because of a family death, MacDonald said.