Budget Vote Holds Line on Medical Care for Poor

Fighting back tears and apologizing when they spilled over, 56-year-old Bill Piper of Anaheim told Orange County supervisors Thursday that his wife’s illness had ruined his family financially. Don’t let it happen to others, he pleaded.

“We were very proud, productive, middle-range people,” Piper told the supervisors at a hearing on the fiscal 1986-87 county budget. “We’ve been busy working, producing, since we were 12 years of age.” Now, because of his wife’s medical problems, “we’ve lost just about everything.”

Laid off from a job in the electronics industry and unable to afford private health insurance, Piper wove a tale of steep medical bills and bureaucratic delays.

“Based on our system, you are forced to deplete everything you have, reduce yourself to nothing,” before becoming eligible for care under the county’s indigent medical services program, Piper said.

Piper, whose wife suffers from a disease similar to multiple sclerosis that destroys nerve fibers, was testifying in the second day of public hearings on the county’s proposed $1.45-billion budget, which is expected to be formally adopted in late August.

No Additional Money

After hearing from Piper and others, however, the supervisors approved the portion of the proposed budget that includes the medical services program exactly as recommended by the county administrative office, with no additional money.

As approved, the $399.5-million portion of the budget labeled “human services,” which includes funding for the Social Services, Community Services and Health Care agencies, contains $34.7 million for medical services for the indigent. All of that is state money processed through the county and spent at hospitals that contract to treat the needy.

A task force report, calling for more money for the medical services program and looser restrictions on eligibility, was released last week. The study was conducted by researchers from the UCI Medical Center, including Dr. Lloyd Rucker, an assistant professor of internal medicine at UC Irvine. It drew withering comments from supervisors at the hearing.

Board members complained that they had not been given copies of the report, although its contents were reported to the press last week.

Supervisor Roger Stanton said that the conclusions came from a group “with no particular credentials for research,” and said the task force’s relations with supervisors indicated they were “following perhaps a page from a 1960s community organizing manual.”

Supervisor Harriett Wieder accused Rucker of “smirking” when he testified Thursday. Supervisor Bruce Nestande described him as “standing there so smugly.”

“You’re not the only humanitarian in the crowd,” Nestande said. “We care about people, too.”

Rucker said that some indigent people had been turned away from hospitals by administrators who said they had “seen their quotas of IMS (patients) for the day,” and that others were rejected because of lack of money, although they had medical problems that would eventually become life-threatening.

Nestande demanded documentation of such instances and promised, “I’ll personally follow through and see what happened.”

Also testifying Thursday were a doctor providing free services at a medical clinic for the poor in Costa Mesa, and a priest representing Catholic Charities.

Task force member Jean Forbath, a longtime worker on behalf of the poor, estimated that there are 150,000 people in the county without health insurance of any kind, most of them workers with too much money to qualify for the program for indigents, but too little money to buy medicine or pay doctors’ bills.

“They fall through the cracks of our local health-care system,” she said. “They are ill. They need care, and they can’t find it in Orange County.”

But Tom Uram, director of the county Health Care Agency, said that the indigent medical services program was “brilliant,” and hospitals contracting to serve the poor “give service first, then (worry about) eligibility.”

Turning to another portion of the budget Thursday, the supervisors voted in favor of a $165-million expansion of John Wayne Airport, which will be financed with revenue bonds. Also winning approval was an $11.1-million outlay for schematic designs for the proposed 1,500-cell jail at a site half a mile from Anaheim Stadium. The estimated cost for the jail is $141 million.

Supervisor Ralph Clark, whose district includes Anaheim, voted against the proposal, declaring that the jail “will never be built. You mark my words. It will never be built.”

Bud Smull, speaking for the Jail Action Committee, a group opposed to the plan, won assurances that the $11.1 million will not be spent until after his group completes a September report on the issue.

The committee, which represents Disneyland, the California Angels baseball team, the Los Angeles Rams football team and the cities of Orange and Anaheim, as well as other businesses and residents, is pushing to have a large jail built in a remote area of the county. Supervisors have never been able to find such a site, though they have searched for years.

One person who came away happy from the hearing was William Steiner of the Orangewood Children’s Foundation.

The supervisors approved $4.7 million to operate Orangewood, the county’s home for abused and neglected children, including $278,000 for increased staff to improve the supervision of toddlers and infants.

Full funding for the 2-year-old facility, built in partnership by public and private groups, and individuals who raised $7.5 million, had been in doubt because of changes in state appropriations formulas.

Budget hearings are scheduled to end Tuesday with approval of spending for the county’s special districts.

PROPOSED COUNTY SPENDING 8% GENERAL ADMINISTRATION AND SUPPORT $115.4 million Tax Collection Government Management Property Assessment 25% GENERAL SERVICES $358.7 million Airport Facilities Election Services Landfill Libraries 19% ENVIRONMENTAL MANAGEMENT $280.1 million Road Fund Flood Control District Harbors Beaches 21% COMMUNITY SAFETY $298.1 million Law Enforcement Fire Department Municipal Courts 27% HUMAN SERVICES $399.5 million Health Care Social Services Community Services Source: Board of Supervisors, LEAVETT BILES / Los Angeles Times