ORANGE COUNTY IN BANKRUPTCY : Program for Pap Smears Could Be Cut

A county program for women with abnormal Pap smears is on a list of recommended budget cuts, possibly removing the only option poor women and teen-agers have for treatment of a precancerous condition, two clinicians who work in the program said Friday.

Staff members have been informed by their bosses that the program is among proposed cutbacks to be presented Tuesday to the county Board of Supervisors, a doctor and another clinician said.

Dr. Lodema Stephens, an obstetrician-gynecologist who works in the program part time, said the adult women and teen-age girls who rely on it often cannot afford to pay a private physician. Without the program, she said, many of them “won’t get treatment until they start bleeding from the cancer and appear in somebody’s emergency room somewhere.”

Even though many of the patients are on Medi-Cal, Stephens said, private physicians often do not accept Medi-Cal patients for non-obstetrical care. The county program charges patients on a sliding scale, she said.

Hugh Stallworth, the county’s public health director, would not say whether the program was among those recommended for closure, saying he and other county officials were ordered not to discuss possible cuts. “All of our programs are on the table,” Stallworth said. “Basically, nothing is sacred. It’s just a matter of prioritizing.”

The program is offered two days a week at the Health Care Agency’s main clinic in Santa Ana, and weekly at clinics in Buena Park, Costa Mesa and San Juan Capistrano. About 16 to 20 women and teen-agers are seen each week, Stephens said, and appointments are backed up for months.

Patients often have genital warts caused by a sexually transmitted virus, said Stephens and the other clinician, who requested anonymity. If untreated, these can lead to cervical cancer, they said. The clinic performs biopsies and provides cryosurgery, which involves freezing abnormal cells so they fall off.

Stephens said the purpose of the program is to detect and remove lesions before they become cancerous, sparing women from a potentially deadly disease and saving the costs of involved treatment.