State Must Pay for County Care Plan, Judge Says : Health: State and county are also told to negotiate a settlement in dispute over responsibility for County Medical Services.

A Superior Court judge Monday ordered the state to pay for San Diego County’s program to provide health care for the medically indigent.

The preliminary injunction, requested by the county, means county supervisors won’t vote today to eliminate several key social programs, including mental health, child abuse prevention and the sheriff’s special tactics unit, said David E. Janssen, the county’s chief deputy administrative officer.

Those emergency cuts had been proposed last week to pay for the medical program.

Although granting the county’s request to make the state pay for the program, Judge Harrison Hollywood again warned the county and the state Monday that his new injunction was intended to force the two sides to settle their dispute over how to pay for the County Medical Services program.

“I am reserving the power to dissolve any injunction that I feel is necessary if the parties do not continue to work in good faith,” Hollywood said.

The state has offered to loan the county $9 million to pay for CMS this fiscal year, but the county rejected the terms offered.

Hollywood said he was trying to preserve essential services for the mentally ill, whose program might have been cut without the order for state funding, and also to level the playing field in the loan negotiations between the county and the state.

“Right now, the terms of that loan are not acceptable to the court,” Hollywood said.

Neither the new injunction nor one he issued last month prohibiting a CMS shutdown will continue after the end of this fiscal year, Hollywood said. After June 30, whether to continue the program and at what level is up to the legislative branch of government, he said.

Monday’s injunction was the latest chapter in a three-party battle.

Legal Aid lawyers sued the county on behalf of clients when the county announced its intention to end CMS because state funding ran out Dec. 24. It was in that suit that Hollywood issued his previous injunction against eliminating CMS.

The county then filed a cross-complaint against the state, saying the program was a state obligation. It was in this cross-complaint that Monday’s injunction was issued.

CMS is the program of last resort for people who have no health insurance, and earn too much money to qualify for Medi-Cal but too little to pay for their own medical care. Its 25,000 clients every year largely are in the program because of life-threating chronic illness such as heart disease or traumatic events such as auto accidents.

The program received only $19.8 million this fiscal year from the state out of a $41-million budget. It previously had been funded totally by the state.

Hollywood’s order brought a quick and extensive protest in court from Richard T. Waldow, a deputy attorney general in Los Angeles who is handling the case for the state.

“The court’s finding of the basis for preliminary injunctive relief is really going beyond the court’s province,” Waldow said.

But he was quickly interrupted with a warning from Hollywood.

“If you take that position and want to appeal, or if you say, ‘We’re not going to follow the court’s ruling in this matter,’ I will have to rethink very carefully the injunction against the county (prohibiting it from closing the program),” Hollywood said.

That would leave the state and the county to take “the political heat” for the end of CMS and the dooming of people across the county to sickness and perhaps death, he said.

Another hearing, on the specifics of how much the state will pay and when, will be held next Tuesday.