Maternity Patients Sought by Clinics : Oxnard: County medical center seeks OK for a facility to vie with Community Memorial for Medi-Cal recipients.

Call it the battle for babies.

Six weeks ago, Community Memorial Hospital opened a family care clinic near one of Oxnard’s poorest neighborhoods and has been drawing in 10 to 12 new mothers a week.

Now, Ventura County Medical Center is asking the Board of Supervisors today to approve a new county clinic about a mile away, even closer to the La Colonia neighborhood.

Why the rush to serve some of the county’s neediest residents, those typically shunned by the health care establishment?

The quirks of the state’s Medi-Cal system and the realities of health reform have suddenly made it profitable to care for some low-income residents, particularly expectant mothers.

“The changing reality of what’s happening in medical care in America has stimulated private physicians to expand their practicing opportunities,” said Dr. Richard Reisman, the medical director of Community Memorial’s Center for Family Health. “We are late comers, but we’re very serious about being here now.”

But county doctors say the private clinic could end up skimming off the only patients who bring any substantial reimbursement from Medi-Cal, the state’s program for low-income health care.

“They are taking away our only real subsidy and making it more difficult for us to serve those people that nobody else wants,” said Brian Prestwich, a family practice doctor at the county’s Las Islas Family Medical Clinic in south Oxnard. “That’s my concern.”

Leaders in the predominantly Latino neighborhood remain skeptical about both clinics. Many remember angrily how the county shut down a small clinic there just two years ago. Residents were expected to travel to Las Islas or use a small clinic run by Clinicas del Camino Real.

“I think the people who used the facility were shocked,” said Carlos Aguilera, a community advocate. “I think they were stabbed in the back.” He is not impressed with Community Memorial’s efforts either. “Isn’t it funny when one of the most expensive hospitals in the county, who would probably kick the poor in the teeth before they let them in, now want to make a profit on them?” Aguilera said.

The debate over the two clinics underscores a deeper division between the county medical center and the private hospital that sit across the street from each other in Ventura.

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Community Memorial administrator Michael Bakst sees the county’s new clinic as the latest in a series of efforts to compete with his institution. He has protested plans to add a new outpatient wing to the public hospital and to provide health care there for county employees. “I don’t think that government has a right or a role to compete with the private sector,” Bakst said last week.

But county supporters say it is Community Memorial that has moved into the public hospital’s territory. In addition to opening the clinic, the private hospital has run newspaper ads with huge pictures of babies.

With thousands of patients who pay nothing at all, the county system relies on pregnancies--and the nearly $1,000 in reimbursement for each patient--to offset its losses.

“I think that’s a particularly offensive and specious argument,” said Reisman, the obstetrician-gynecologist who directs the Community Memorial clinic.

The county, he said, is essentially asking low-income, pregnant women to subsidize health care for the rest of the community.

“Who should subsidize that: the person with Medi-Cal, the paying patient or the taxpayer?” he asked.

Community Memorial, which just received a contract to accept Medi-Cal payments, now offers low-income residents a choice, he said.

“If they choose to come to a private setting, with board-certified physicians rather than residents, they should have that right,” Reisman said.

The county hospital has a family practice residency program, but also employs board-certified doctors. “All of our deliveries are performed or supervised by the obstetrics department,” said Pierre Durand, county hospital administrator.

Jennifer Hilton and James Dykstra, who moved to Ventura County this spring, did not want to deliver their baby at the county hospital because they feared the maternity ward would be overcrowded.

They chose the Community Memorial clinic, and came to the hospital Monday morning for the birth of their daughter. Dykstra said the experience was far better than their last child’s birth at an Antelope Valley hospital.

“Nicer, quieter, more attention,” he said. “Everything is explained. It’s not just done.”

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But critics question whether that sort of choice is available to all prospective Medi-Cal clients. In most cases, the state pays far less for medical procedures than private insurance companies do. “The bottom line is if you’re not pregnant, if you’re a child who is ill or an adult who is ill, there are very few options for you,” said Prestwich from the county clinic.