County Pressured to Devise Plan to Share Tobacco Settlement

A negotiator for six private hospitals said Friday he has given the county one month to come up with a plan to share the $260-million tobacco settlement or risk seeing the hospitals unite behind a ballot measure that would take the entire settlement from the county.

“If we don’t get significant movement in 30 days we’ll just stop wasting the county’s time,” said James Lott of the Healthcare Assn. of Southern California, following two hours of talks with county interim Chief Administrative Officer Harry Hufford.

Hufford described the meeting as “good” but would not say what sort of compromise he would be willing to recommend to the Board of Supervisors.

“My position is, let’s see how much progress we can make in the next 30 days . . . to try to address the issues and determine if we can come up with an agreeable solution between the county and the private hospitals,” Hufford said.

He and Lott are expected to meet again next week to discuss more specific details. Lott said hospital executives are skeptical a compromise can be reached, primarily because they distrust the administrators of the Ventura County Medical Center, the county’s public hospital.

He said executives believe Hufford, a former colleague of Lott’s in Los Angeles County, is serious about wanting to compromise. But hospitals don’t know how much influence Hufford carries with the supervisors.

“If it wasn’t someone like Harry coming in, I don’t think we’d be talking at all,” Lott said.

The hospitals also want a guarantee that any compromise would be carried out over the 25-year life of the $260-million settlement, a stipulation supervisors may find difficult to guarantee.

“We don’t have to have signed contracts, but we’ve got to have a clear, definitive policy” approved by the Board of Supervisors, which would reimburse private hospitals for indigent care, Lott said.

Friday’s lunch meeting was at least the third Hufford has held with the association and individual hospital executives since Community Memorial Hospital in Ventura announced plans last month for a November ballot initiative that would turn the settlement over to private health-care providers. The measure, being circulated for signatures at malls and grocery stores, excludes the county from receiving any of the money.

Hufford and county supervisors oppose the measure, and the county’s lawyers say they believe it is illegal.

Community Memorial says unless supervisors commit to spending the settlement dollars on direct services, the initiative would be the only way for residents to be sure the money is spent on health care. Supervisors have voted to spend the $10.6 million in settlement dollars they have received this year to pay off a federal health-care fine and to offset declining year-end revenues.

The hospital also says it is fair to exclude the county hospital from funding because it already receives subsidies to care for the indigent.

Mark Barnhill, a spokesman for Community Memorial, said the hospital is interested in hearing what Hufford proposes but said there are “no plans at this point to pull the initiative off the table.”

The county hospital provides the bulk of indigent care to county residents, although private hospitals in recent days have taken issue with just how much care that is. The county says it provides about 87% of indigent care. Lott said that number is a misrepresentation and argues it’s really only about 52%, but could not immediately offer statistics Friday to back up that claim.

Of the county’s seven privately operated hospitals, only Ojai Valley Community Hospital did not participate in Friday’s talks, Lott said.

While the other private hospitals have yet to endorse Community Memorial’s initiative--some are reluctant to cut the county out of the picture and others fear the county will punish them if they do--the threat that they might has forced the county into negotiations.

Supervisor John Flynn, who earlier said he opposed giving private hospitals money, said Friday he would be “willing to commit to something” so long as it was based on a formula that reimbursed all hospitals--including the county’s--based on care provided to the indigent.

Supervisor Frank Schillo said he would only agree to a deal with hospitals that, in return, promised to repudiate Community Memorial’s initiative proposal.

“If they want anything at all, they’d better get on board,” Schillo said.

Meanwhile, Schillo said negotiations can only work if executives at each hospital agree to meet individually with Hufford.

Lott said hospital executives are reluctant to meet one-on-one with Hufford because they fear a divide-and-conquer strategy. But last week, Community Memorial’s executive director, Michael Bakst, met privately with Hufford for lunch. And at least one other hospital, whose officials asked that it not be identified, has agreed to meet privately with Hufford.