County to Seek Hospitals’ Support

Hoping to avert a political or legal showdown, Ventura County officials will begin talks today with representatives of seven private hospitals that want to tap into the county’s $260-million tobacco settlement.

Chief Administrative Officer Harry Hufford and Health Care Agency Director Pierre Durand are scheduled to meet this afternoon with James Lott, vice president of the Healthcare Assn. of Southern California, and the group’s local representative, Monty Clark.

Hufford and the Board of Supervisors hope to convince the hospitals not to support Community Memorial’s pursuit of a November ballot initiative that would divert all of the tobacco money from the county to private health care providers.

Although some private hospitals don’t favor excluding the county and its public hospital, they do want a guarantee that all of the settlement money will be spent on health care. They also want financial assistance from the county during a time when hospitals are struggling with shrinking revenues and growing numbers of uninsured patients.

“The onus is on them, we think,” Lott said of county leaders. “[They] don’t want the private hospitals supporting the CMH proposal. That’s obviously why they called this meeting. So what are [they] going to offer the private hospitals as a substitute?”

The county wants the hospitals to provide specific data to back up their argument that they deserve any subsidy on top of the nonprofit tax status six of the seven hospitals already enjoy. “Not just ‘We want the money,’ ” Hufford said.

Except for Los Robles Regional Medical Center, the remaining six general hospitals in the county are exempt from paying property taxes because of their nonprofit status.

Even though Community Memorial Hospital is a member of the regional health care association, Lott’s negotiations won’t stop the hospital from going forward with its proposed initiative, said hospital spokesman Mark Barnhill. By Monday, the hospital could begin gathering the 21,000 signatures needed to put the initiative on the ballot.

Barnhill said Community Memorial remains optimistic other hospitals will join the initiative effort. Trustees of the individual hospitals are expected to vote on whether to endorse the initiative by the end of the month.

Some hospitals may not support the initiative if the county commits to spending the money on health care and offers some financial assistance to the private sector, Lott said.

“If Harry would do that much, it could influence greatly what these boards decide on the Community Memorial initiative,” Lott said.

“But I don’t know that he’s prepared or even empowered to do that.”

While supervisors have agreed to let Hufford enter into talks on their behalf, they remain wary of offering any cash subsidies. They argue that the county has incurred huge costs for treating uninsured sick smokers over the years. They also point out that it was taxpayer money that was used to pay for the legal fight that led to the settlement.

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“It’s like if I had $100 and someone came to me and said ‘Someone just stole $100 from me. Let’s compromise--you give me $50,’ ” said Supervisor John Flynn.

Even if hospitals could show that they went “beyond the call of duty” to treat indigent patients, Flynn said he still wouldn’t favor a cash subsidy. Instead, he would prefer a solution such as “putting a public doctor into a private hospital to take care of indigents.”

Meanwhile, some hospitals fear that they could lose more than they would gain by backing the initiative. Steve Lopez, chief financial officer for Santa Paula Memorial Hospital, said his hospital has asked county officials to consider arrangements that might steer more Medi-Cal patients or pregnant women its way.

And the county has been generous in allowing the Santa Paula hospital to transfer many indigent patients to Ventura County Medical Center for care, once they are in stable condition.

If the hospital supports the initiative, it risks losing the county’s good will, Lopez said.

Lott said he has asked each of the hospitals to provide him with detailed information on the amount of indigent care they provide, so he can negotiate in a way that benefits them all while at the same time satisfying the county’s demands.

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Although on opposite ends of the bargaining table today, Hufford and Lott were allies in the 1970s. Hufford, then chief administrator for Los Angeles County, and Lott, then a lobbyist for the county’s health department, were urging federal officials in Washington at the time to increase public health funding.

The two remain friendly, and said they are hopeful their history together would serve them well as talks get underway.

From his experience in the public sector, however, Lott conceded, “I’m not looking to walk out of the meeting [today] with any sort of solution.”