Health Care Advocates Push for Initiative on Tobacco Cash

Health care advocates will try to get a measure on the November ballot to allot 80% of Orange County’s share of the tobacco settlement money to health care, with the remaining 20% going to law enforcement, according to a summary of the proposed referendum obtained by The Times.

The ballot measure otherwise would cut county government entirely out of the $900 million coming to Orange County in payouts over the next 25 years from the national settlement of lawsuits against the tobacco industry.

A coalition of health care advocates--including Orange County’s major physician and hospital groups and health clinics, the American Assn. of Retired Persons and community representatives--will kick off their campaign to gather signatures for the measure at a news conference today, hosted by the Orange County Medical Assn.

Supporters of the initiative must gather valid signatures from 71,206 registered county voters by the end of May to qualify it for the November ballot. If they are successful, it would be the second major challenge to the authority of the county Board of Supervisors after Measure F, an anti-airport initiative on the March 7 ballot.

Supervisors have voted twice to spend the vast majority of the annual $35 million to $40 million in settlement payments on reduction of the county’s bankruptcy debt and on jail projects. Health care would get less than $8 million annually over the next 10 years.

“Debt reduction is the board’s No. 1 priority,” Supervisor Todd Spitzer said. He called the proposed ballot measure “a shortsighted response” that would directly restrict the county’s ability to pay off debt and reduce interest payments.

“That is what the debate is all about,” Spitzer said.

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After six months of negotiations over how best to divide the tobacco cash, county officials, several supervisors, Sheriff Michael Carona and members of the health care coalition failed to reach a compromise.

Coalition members, who wanted most of the money to be spent on health care and anti-smoking programs, said Wednesday they are fed up with the county’s position.

They say the county for years has failed to provide adequate funds for clinics, hospitals and physicians who provide the equivalent of hundreds of millions of dollars in uncompensated care for indigents.

“The initiative is about money that should be spent on health care and not other non-health-related issues,” said Jon Gilwee, spokesman for the Healthcare Assn. of Southern California, a hospital trade group. “It is about doing the right thing with the money.”

The hospital trade group was among the last to sign on to the initiative, holding out for a possible settlement.

“We have seen very little movement and see this as a viable effort,” Gilwee said of the effort to get a measure on the ballot.

The coalition proposal would give 19% of the annual allotment to senior health care programs; 20% to community and hospital clinics; 23% to physicians and on-call doctors who staff emergency rooms; 12% to anti-smoking, addiction and mental health programs; 6% to hospitals for uncompensated care at emergency rooms; and 20% to law enforcement through the sheriff, according to the summary.

The initiative would provide an escape clause that would allow supervisors to appropriate some or all of the annual tobacco settlement in a fiscal emergency, defined as a decline of 10% or more in the county’s general fund.