Medical Agencies Expect More Clients, Fewer Funds : Health: The county’s financial crisis will add more pressure to nonprofit providers who have already cut to the budget bone and are now ‘into the marrow,’ one official says.

About 50 medical providers met Thursday to discuss how Orange County will cope with a health-care crisis and how nonprofit agencies will absorb new demands for services as the county’s financial debacle forces deeper cuts in funding.

“We’ve been asked repeatedly to cut to the bone,” said Barbara Talento, chairwoman of the Orange County United Way’s Health Care Council, a coalition of about 70 health providers who called the meeting.

“But now we believe we are into the marrow,” she said. “As the people try to pick up the slack for the county, it’s going to cost them budget increases. After a while, it has much more than a trickle-down effect. It’s going to mean an avalanche.”

Because Orange County lacks a county-run hospital, private health agencies are largely responsible for providing the range of health services, including care for the poor. As a result, when the county slashes its budget, these private organizations bear the brunt, said Orange County Medical Assn. spokesman Samuel Roth.

As it is, many organizations are operating on tight purse strings.

“Community clinics like us are already maxed out,” said Russell Inglish, head of the Coalition of Orange County Community Clinics, a group of 13 clinics that served more than 100,000 patients last year.

“There comes a time when nonprofits cannot carry the load,” said Mottie Andrews, head of Maternal Outreach Management System, an Irvine-based agency that provides prenatal care to more than 1,000 low-income women a year.

With funding cuts, community health providers will not only suffer an increased work load, Roth said, but patients who can pay are likely to pay higher insurance premiums and fees.

To the group’s dismay, Ronald DiLuigi, assistant director of the Health Care Agency, said that in addition to the $3 million already slashed from the agency’s budget, another $7 million might be cut. However, he said, the Board of Supervisors has “not made determinations on where those cuts will come from.”

DiLuigi said the county is considering asking the state for a temporary waiver of its obligation to provide the matching funds needed to receive certain state and federal grants. As it is, the county must contribute $27 million in matching funds to round out the Health Care Agency’s budget of more than $220 million.

The Health Care Council is opposed to the waiver, because it fears the county will permanently reduce the amount of money it devotes to health care.

“We consider it a calamity,” said Chauncey Alexander, the council’s founder. “(That money) was developed principally to protect health services because of problems county and state have (encountered).”