State May Give S.D. Health Care a Boost : Money: Legislative compromise could provide $46 million more for the county’s previously slighted health-care programs.

Long accused of having slighted San Diego County over the years, the Legislature is considering a budget deal that could send an extra $46 million to the area’s overwhelmed programs for indigent health care and the mentally ill.

The compromise would bring extra money to San Diego County and other fast-growing suburban areas--Orange, Riverside, San Bernardino counties--as part of a “realignment” plan to shift responsibility for certain state-mandated public and mental health programs to local officials.

If approved, possibly as early as this week as part of an overall budget package, the deal could give San Diego County $9.18 million more a year, starting in 1992 and for five years thereafter, according to preliminary figures released by county officials Wednesday.

Officials with the County Supervisors Assn. of California, which helped fashion the deal, cautioned that these numbers are estimates and may change before lawmakers approve the measure this week.

But local legislators hailed the realignment proposal as a breakthrough in taking care of what many have long complained to be the state’s historic practice of sending less than the fair share of public health dollars to San Diego County.

“It’s been a terrible, terrible situation,” said Sen. Lucy Killea (D-San Diego). “In other words, human life and human health in San Diego has been a lot less valuable than anyplace else, is sort of what this (historic under-funding) says. And that’s just completely unacceptable.”

Assemblyman Steve Peace (D-Rancho San Diego) said the extra money is the only glimmer of “good news for people” to come out of the state’s budget crisis over a monumental $14.3-billion deficit.

“Everything else in this whole budget scenario is nothing but bad news,” he said.

The proposed compromise would affect four health programs now funded by the state but administered by the counties. They include preventive health programs, such as immunization for measles; “indigent medical services” for people without Medi-Cal and too poor to pay for a doctor; mental health services and payments for mental health hospital beds.

The state pays for these programs with a formula that was created soon after Proposition 13, when San Diego and other suburban areas had relatively little demand for the services. In addition, county officials at that time opted to forgo some state offers of federal grant money. The resulting system sends disproportionately less to San Diego than other counties that lined up for state assistance.

In recent years, the disparity has grown into a crisis as Sacramento has cut back on the funding while the county’s population of needy has boomed.

Saying it faced bankruptcy, the county resorted to suing the state for more money--a move that resulted in at least one preliminary finding that San Diego has been shortchanged when it comes to money for mental health hospital beds.

Local officials have even made their case to favorite son Gov. Pete Wilson, who earlier this year proposed that the counties take over full responsibility for the poverty and health programs. The move would not only relieve the state of a $2.17-billion burden, it would give county officials direct control over how they care for the poor and mentally ill.

To help counties pay for the programs, Wilson has proposed raising an estimated $1.6 billion from a new 1/2-cent sales tax and another $769 million statewide from increases in vehicle registration fees. That package would not only cover the current costs but provide an estimated $165 million a year to make up for historic inequities in state funding.

The realignment package would give the county an extra $9.18 million a year, according to John Sweeten, director of intergovernmental affairs. That amount includes an extra $2.5 million for preventive health programs, $1.7 million for mental health beds, and $983,000 for medically indigent services. Those increases would be further augmented by an additional $4 million a year.

County Supervisor John MacDonald said the extra money, if approved by the Legislature, would help lift the county’s per capita spending for the programs from its standing of 56th out of 58 counties. He said the county now receives about $16 per person, contrasted with the state average of $32.

“Although it wouldn’t bring us to full equalization over the five-year period, it will go a long way to addressing those inequities,” MacDonald said.

Legislators have been fighting for years to have the state send extra money to San Diego, and they said Wednesday that Wilson’s interest in the issue helped--if not directly, then with the implied threat that he would veto any plan that came up short for his hometown.

“There’s no question that representatives from the area . . . all played that card,” Peace said. “Wilson’s people never played it, but folks from San Diego used it. . . . There was certainly a perceptual advantage to it.”