County to Issue Hospital Certificates : Construction: Supervisors first want a report on the soundness of financing for the medical center expansion.

Although worried about the potential effects of Orange County’s investment debacle, the Ventura County Board of Supervisors on Tuesday approved issuing $51 million in bond-like certificates to build a new wing at the county hospital.

But the board directed county Auditor-Controller Thomas Mahon to report on the soundness of the finances for the Ventura County Medical Center expansion before the certificates are actually sold to the public.

The report is due in March and the certificates would have to be sold by September, officials said.

“I think what’s happened in Orange County has been a red flag that we need to be more careful than we’ve been in the past,” Supervisor Vicky Howard said.

Mahon assured the board that while there may be some fallout from the Orange County mess, he did not expect any lasting harm to Ventura County’s credit rating or borrowing practices.

“We’ve always been able to distinguish Ventura County from the rest of California” in terms of its credit rating, Mahon said. “We have been able to get our rating upgraded despite the fact that the state and other counties have gone down.”

Yet taxpayer advocates urged the board to reconsider or delay the sale of the hospital certificates because the county has no guarantee that the state will pay 70% of the project’s costs, as promised.

“There has been talk about this 70% reimbursement, but whether or not that is a specific ongoing commitment is still not clear,” said Michael L. Saliba, executive director of the Ventura County Taxpayers Assn.

Nor is it clear, Saliba said, how the Orange County situation will play out or how many illegal immigrants will stop using the county hospital because of Proposition 187.

A 1988 state law provides funding for public hospital projects based on the percentage of poor patients treated. To qualify for the funding, a hospital must have a patient load that is at least 50% indigent or Medi-Cal insured.

The percentage of such patients at the county hospital is 70%, which accounts for its 70% rate of reimbursement.

But Saliba and others argued that since the state reimbursement must be approved each year, it could be reduced or disappear altogether because of an uncertain economy.

But Mahon told the board that state officials have assured the county that it will receive its money, half of which would come from federal Medicaid funds.

“At present, the information we have is that this is as good as it gets as far as money coming from the state and federal government,” Mahon said. He said, however, that he would include additional information about the state funding in his March report.

Saliba also voiced concerns that Proposition 187--the voter-approved initiative that bars non-emergency health care to illegal immigrants--could mean fewer patients and reduce the need for a new hospital wing.

But hospital officials said the number of illegal immigrants treated at the hospital is so small that the initiative will not affect state funding.

At the hearing, two hospital physicians urged the board to move quickly on the expansion plans.

“I’m training physicians in buildings that will soon fall down,” said Dr. Lanyard Dial. “The rains leak through every day, and yesterday was no exception. It’s been a mess. We have to do something. We can’t delay this a year or two or I’ll be practicing in a parking lot.”

Backers have long said the new wing is needed because portions of the existing hospital are 70 years old and uninhabitable. Much of the new space would replace condemned buildings or house services now offered in leased buildings.

No one showed up from rival Community Memorial Hospital to argue against the project, but county hospital physician David Mackenzie chided Community Memorial for its lawsuit that charges the county with competing for private patients.

“I think it’s elitist because it tries to prevent a modern state-of-the-art annex from being built when the aim of the annex is to facilitate treatment to the poorest of the poor, the mentally disabled and the homeless,” he said.

Donald L. Benton, a Community Memorial trustee, said in an interview that Mackenzie’s comments were misleading. He said Community Memorial had to sue the county hospital because it is competing directly for patients by setting up clinics around the county.

Benton said the county is taking a big gamble that it will win the lawsuit. He said it would be prudent for the supervisors to postpone issuing the certificates until the case is settled.