Courts Keep Health-Care Program for Poor Alive Until June 30 : Medicine: The state is ordered to reimburse the county for the unfunded costs of the program. But for now, it’s a Sacramento ruling that is keeping the care going by releasing $8.3 million.

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Doubts about whether health care for the medically indigent would survive until June 30 were resolved this week, and the legal wrangle over it cooled--but not because the county and the state are any closer to reaching agreement.

Superior Court Judge Harrison Hollywood signed an order Thursday requiring the state to reimburse the county for unfunded cost of the County Medical Services program. The state had vehemently fought such an order.

But--for the moment--$8.3 million of the money needed to keep the program going through June 30 will materialize, not because of the state but because of a court ruling last week in Sacramento.


On April 23, a Superior Court judge there denied an injunction requested by the state’s school districts. They wanted counties prohibited from spending millions of dollars in surcharges they had planned to collect from school districts this fiscal year.

The fees, to cover the cost of the county’s tax-collection apparatus, were authorized by the Legislature to make up for state cuts in medical funding to counties. But school districts sued.

William J. Kelly, assistant auditor for San Diego County, said the Sacramento ruling last week made $8.3 million available to pay for CMS this fiscal year.

Consequently, the heated court dispute before San Diego’s Judge Hollywood suddenly moved from a life-and-death case to being more of an academic exercise.

The $8.3 million also eliminated the need for $9 million in drastic budget cuts that the county had proposed to make up for what it was paying to keep CMS going. These included cuts in key child abuse, sheriff’s and mental health programs.

The order Hollywood signed Thursday eventually could require the state to repay the county for any money it spends on CMS beyond the $8.3 million provided by the school district money, said Valerie Tehan, deputy county counsel in the case.


The ruling also clears the way for the county to spend $1.1 million in tax-collection fees it has assessed special taxing districts in the county.

Kelly said his office expects to complete a fiscal analysis today to determine whether any additional money will be needed to cover the cost of the CMS program.

Unfunded, CMS has been piling up bills at a rate of $112,000 a day since Dec. 24.

Meanwhile, the original CMS lawsuit remains in San Diego County Superior Court, although with less impetus for quick action.

On Thursday, Hollywood turned the case over to Judge Michael I. Greer for consideration of the substantive issues of the case. The next hearing is scheduled for June 25.

When the suit was first filed in March by Legal Aid, Hollywood issued an order prohibiting the county from ending CMS because patients would die without it.

CMS reimburses doctors and hospitals for caring for about 25,000 people annually who have no health insurance and need care for critical injuries or life-threatening chronic illness. Clients in the program cannot qualify for Medi-Cal, but have incomes too low to pay for their own medical care.


Later, after the county filed a cross-claim against the state--saying it was a state obligation to pay for the program--Hollywood used the same justification for ordering the state to pay for the program while the dispute was being litigated.

Now that the immediate threat of ending CMS is over, future court actions will pertain to legal issues such as whether it is a state or a county responsibility to pay for the CMS program, said Anson Levitan, the chief Legal Aid attorney in the case.

But Legal Aid will watch what happens in the new fiscal year carefully, he said.

“There’s an injunction in effect saying the county has to provide the care,” Levitan said. “Unless the law is changed, that obligation would still remain.”