Health Care to Split Tobacco Windfall

After emotional pleas from impoverished residents, and an offer too good to refuse from health officials, county supervisors on Tuesday voted to keep an earlier promise to evenly split this year’s $28.4-million tobacco settlement funds, rather than pay off debt by cutting health-care programs.

The decision was made after a week of tense negotiations between health-care leaders, county officials and the board. Supervisors said two weeks ago that they wanted to use more tobacco money to pay down the $950-million bankruptcy debt.

What may have tipped the scales was a last-minute $1-million pledge by health-care leaders from their portion to help construct a water quality laboratory that the county sorely needs to ensure better ocean water quality.

Just before Tuesday’s meeting, Julie Poulson, interim director for the Health Care Agency who was instrumental in brokering the deal, told health-care leaders she was confident that Supervisor Jim Silva could be counted on as the swing vote to restore health-care funds, joining Tom Wilson and Todd Spitzer. Silva is interested in keeping the coastal waters in his district clean.

In the end however, Chairman Chuck Smith and Supervisor Cynthia P. Coad also voted for the arrangement, expressing satisfaction with the brokered agreement, including provisions such as a mobile health van for the county’s motel children and one for the elderly, which are sensitive needs in their districts.

Only two weeks ago, Silva, Smith and Coad angered health-care leaders when they said they wanted to reconsider the settlement funding formula. Tuesday, those three supervisors were singled out by members of a church-based organization.

“My husband has insurance, I don’t,” said Carmen Silva from Santa Ana’s Delhi area, and a member of the Orange County Congregation Community Organization. “When I need medical help, I go to Mexico three times a year. [But] I’m afraid of an emergency. We’re desperate. Mr. Smith, can you imagine yourself in this situation?”

Paty Madueno of St. Joachim Church of Costa Mesa estimated that 50% to 60% of the organization’s members have no health insurance. Madueno told the supervisors that cutting any money for health care would be “an injustice” to the working poor.

“Smith, Silva and Coad, do the right thing for our families,” Madueno pleaded.

After the decision, health-care leaders filed out jubilantly from the meeting, followed by Poulson and members of the church group. As she got to the corridor, Poulson was greeted with hugs and congratulations.

“I was surprised that we got all five votes, but I’m glad we did,” said Michele Revelle, a Orange County Medical Assn. spokeswoman. The association had taken a lead role in the passage of Measure H in the Nov. 7 election. The measure will spend 80% of future years’ tobacco money on health care, and the remainder on public safety. It is supposed to take effect July 1, 2001.

Medical Assn. Offer Made the Difference

The board recently voted 3 to 2 to file a lawsuit to test the constitutionality of Measure H. Dissenting were Spitzer and Wilson. But in a Dec. 1 letter to the board, Revelle outlined the medical association’s willingness this year to cede more than $1 million to build the water quality lab, reducing a proposed $4-million allocation to emergency medical services and on-call physicians.

“We did that as a matter of goodwill to the board,” Revelle said, adding that in the wake of last year’s beach closures in Huntington Beach due to high bacteria, many residents listed clean ocean water as a priority in a county poll.

As the association’s public affairs director, Revelle already had negotiated, though unsuccessfully, with the board on tobacco funds. She came up with the idea to sweeten the agreement but needed final approval from the association’s board of directors, which she got early last week.

“I wanted to pick something, something significant enough to make a difference before the board,” she said.

The lab was on the county’s priority list, but was unfunded, Poulson said.

For Wilson and Silva, who have pushed for improvements along the county’s 42-mile coastline, a source of additional money to build the laboratory was welcome news.

“Both Supervisor Wilson and I appreciated that money very much,” Silva said after the meeting. “But I had never talked to them about that money prior to the vote today. I was pleasantly surprised.”

At the meeting, Smith, who had urged the board to reconsider the tobacco formula, read from a prepared statement outlining his support for health programs.

“I was the one to defer this item,” Smith said, but he meant only to reconsider tobacco allocations, not to sacrifice health care in favor of debt reduction. “It was never my intent to do that.”