Health Care Coalition Has Early Edge in Tobacco Row

A health care coalition planning to ask voters to allot 80% of national tobacco settlement money to health care appears to have some distinct advantages in the prospective campaign despite Orange County’s reputation for being tight-fisted on public spending.

Not the least of those advantages is a substantial campaign war chest built on contributions from hospitals and doctors, and volunteer power from several grass-roots senior, health and community groups, such as the AARP.

Also, the Orange County Board of Supervisors, which on Tuesday voted 3 to 2 against a compromise that would have given 60% of an estimated $763 million to health care over the next 25 years, cannot use county funds to campaign against the coalition’s proposed measure for the November ballot.

However, board Chairman Chuck Smith said Wednesday that he would campaign against the initiative if the coalition’s 117,000 signatures filed Wednesday with the county Registrar of Voters are sufficient to certify it for the ballot.

The board majority also could try to mount a court challenge to the initiative, which would allot 80% of the annual tobacco revenues to health care and 20% to law enforcement, which could include addiction services at the jails. The county is projected to get an average of $27.26 million a year for 2 1/2 decades.

“This initiative would bind the Board of Supervisors to a minimum level of spending that I feel is unconstitutional,” Smith said Wednesday. “We could file a legal challenge to keep it off the ballot.”

The board majority also could try to preempt a vote by selling the county’s stream of tobacco cash on Wall Street prior to the election in exchange for a lump sum payment--a fiscal device known as securitization.

“Securitization has always been a possibility,” said Supervisor Cynthia P. Coad, adding that she is committed to moving ahead with jail expansion and building addiction treatment facilities for inmates as soon as possible.

Such moves could have political consequences, though, for Supervisors Smith, Coad and Jim Silva, who voted against the 60%-40% compromise plan reached after three weeks of intensive negotiations between health care advocates and county officials.

Another tactic the board majority could try is placing a counter measure on the ballot. Coad offered a possible alternative Tuesday: a 50-50 split of the first year’s tobacco settlement funds, with a reevaluation by the board a year later. Coad’s plan was supported by Silva and Smith. Supervisor Tom Wilson voted against it.

Supervisor Todd Spitzer, who had negotiated the 60-40 compromise, took a break during the discussion and declined to be recorded on the issue when he returned.

Spitzer on Wednesday called the proposal “one-sided and disingenuous,” and charged that it was concocted on the dais at the last minute “so unreasonable supervisors could appear reasonable during the campaign.”

The health care coalition behind the initiative--Citizens Health Alliance to Reinvest the Tobacco Settlement, or CHARTS--told board members Tuesday that the 50-50 split was unacceptable and vowed to file petitions Wednesday.

The group added a theatrical twist, unloading 15 boxes of signatures supporting a ballot measure from an ambulance, then rolling them into the registrar of voters’ office in Santa Ana on a hospital gurney. Gurney-tenders included state Sen. Joe Dunn (D-Garden Grove), Mission Hospital Regional Medical Center President Peter Bastone, former county supervisor and state senator Marian Bergeson, AARP Regional Coordinator Joe Drlik and Orange County Coalition of Community Clinics Executive Director Marty Earlabaugh-Gordon.

Bergeson said the current Board of Supervisors is not funding care for the poor according to legal requirements it accepted when it sold the county hospital in the mid-1970s.

If the county still operated the county hospital, Bergeson said, “It would cost the county $102 million a year” to pay for charity and indigent care.

The initiative would apportion 19% for services to seniors and the disabled, including transportation, long-term care and in-home support; 23% to pay for indigent care by emergency and on-call physicians; 12% to tobacco prevention and anti-addiction and mental health programs; 20% to community, mobile and hospital clinics; 6% to hospitals to fund uncompensated emergency and trauma care, and 20% to law enforcement.

The registrar has 30 working days to count the signatures. Registrar of Voters Rosalyn Lever said she anticipated the measure would have far more than the 71,206 valid signatures needed to qualify for the November ballot.

The event highlighted the breadth of the coalition, which also includes Auxiliary Bishop Jaime Soto of the Roman Catholic Diocese of Orange, the American Heart Assn., the Orange County Central Labor Council, Planned Parenthood, Latino Health Access, the Arthritis Council, C.J. Segerstrom & Sons and the League of Women Voters. It also has been endorsed by Reps. Loretta Sanchez (D-Garden Grove) and Dana Rohrabacher (R-Huntington Beach), and state Assembly members Patricia Bates (R-Laguna Niguel), Ken Maddux (R-Garden Grove), Bill Campbell (R-Orange), Lou Correa (D-Santa Ana) and GOP Assembly Minority Leader Scott Baugh (R-Huntington Beach).

In opposing the initiative, Supervisor Smith said it would restrict future boards’ use of tobacco funds and does not provide for adequate debt reduction and jail construction.

That position was partially undercut when an assistant to Sheriff Mike Carona indicated his support for the 60-40 compromise, and Carona announced that he was unlikely to oppose the initiative, which guarantees 20% of the money to law enforcement.

One possible source of opposition is the Deputy Sheriffs Assn., which had supported the board last fall when it proposed spending 80% of tobacco funds on jails and debt. General Manager Bob MacLeod said the deputies have not yet taken a position on the initiative.

“If [opponents] spend equal money, there is a good chance they can defeat it,” he said. “The average voter will see it makes perfect sense to get out from under debt.”

However, Jerry Pierson, a political consultant who works with the law enforcement community, predicted passage.

“I don’t see how in the world they can lose when they take it to the people,” he said.

That view was disputed by lobbyist Curt Pringle, former speaker of the state Assembly, who suggested that the county’s fiscally conservative voters might have problems with creating new programs.

“It is very important to bring the issue back to repayment of debt,” he said.