Some Good Medicine for San Diego County : Bill means a new deal on health-fund payments

San Diego County and other counties that have been cheated in state health and mental health funds for more than a decade now stand to benefit from passage of a bill that would begin to right some of those wrongs.

A bill passed June 20 as part of the state budget negotiations stands to net San Diego County about $45 million in health and mental health care funds over the next five years. Approval is a major victory for the county, one that will be complete when companion legislation necessary to enact the change is passed in Sacramento.

San Diego is the second most populous of the state’s 58 counties, but it is near the bottom in the share of health and mental health funds it receives.

The formulas now in place were devised 13 years ago after passage of Proposition 13, which restructured state and local government. But the formulas failed to adjust sufficiently for population growth. That led to so-called “underequity” counties. Over the years, these high-growth counties, such as San Diego and Orange, fell further and further behind in health and mental health funds.

The inequity long has been recognized in Sacramento. But, until this year, the money to bring underequity counties up to par would have had to come from the same pool of money shared by all counties. That’s a zero-sum game that counties such as Los Angeles and San Francisco, which dominate the Legislature, have refused to play. Even though these urban counties receive a bigger percentage of the pot, their share still falls far short of what they need.

Times have changed, and the state has a new governor--not insignificantly, one whose hometown is San Diego. Eager to correct the inequities, Gov. Pete Wilson urged changes in the formulas as part of a massive realignment of health and mental health services. The realignment would shift to counties the responsibility for health programs, and institute increases in sales taxes and vehicle license fees to pay for them.

The underequity counties seized upon this historical program shift as a unique opportunity to correct unfair formulas. Instead of taking money from counties that currently are favored, money for formula adjustments would come from the new sales taxes and vehicle license fees. The realignment measure containing the adjustments has been on Gov. Wilson’s desk pending completion of the budget process.

Credit for getting fairer formulas into the budget must go in large measure to Sen. Marian Bergeson, a Republican who represents parts of Orange and San Diego counties. She is chairman of the Senate Local Government Committee and a member of the joint legislative committee that drew up the realignment package. San Diego County’s assistant chief administrative officer, David Janssen, also deserves credit for helping forge a compromise among county administrators from around the state.

But, ironically, it was the state’s budget crisis that provided the opportunity for change.

It took a little bit of luck and a lot of hard work, but finally it looks as if San Diego County will start getting much fairer treatment. It’s about time.