Budget Deal May Increase Health Funds : Compromise: County leaders hope legislative talks result in an extra $13 million for indigent and mentally ill residents.

Legislative leaders are putting the finishing touches on a budget deal that could send an extra $13 million to Orange County’s overwhelmed programs for indigent health care and the mentally ill.

The compromise would send extra money to Orange County and other fast-growing suburban areas--San Diego, Riverside and San Bernardino counties--as part of a realignment that would raise certain taxes and shift responsibility for those programs to local officials.

If approved, the deal could immediately send an extra $3 million to services providing health care for needy county residents. The compromise would also send another $2 million starting in 1992 and continue for five years, so the value of the total package is an extra $13 million.

The proposal would address a longstanding complaint of local officials, who say residents of Orange County and other growing areas are shortchanged under the state formula for distributing health dollars.

But the deal comes at an uncertain time in state budget talks, so county officials are reluctant to count on any agreements until the Legislature has completed work on the state spending plan.

“It’s an hour-by-hour, play-by-play account at this point,” said Board of Supervisors Chairman Gaddi H. Vasquez. “It’s nice to know we’ve reached some consensus on this issue, but that could change.”

On Tuesday, for instance, county officials had worried that the Legislature was on the verge of abolishing fees for jail booking and property tax collection, which are expected to make up a huge chunk of the funds in next year’s county budget. By day’s end, an Assembly committee had rejected the idea of abolishing the fees, temporarily easing that concern.

Still, Sen. Marian Bergeson (R-Newport Beach) said the latest budget deal could represent a “big breakthrough” because it could help the county and other areas receive their share of scarce state money.

The county has about 8.5% of the state population but receives only about 5.6% of the health care dollars distributed by Sacramento, according to county Budget Director Ronald S. Rubino.

“We’re working closely with Marian’s office in trying to get the Legislature to understand our point of view on equity,” Rubino said. “We’re making progress, but we’re going to be apprehensive until we see a bill.”

The culprit is a funding formula created immediately after the passage of Proposition 13, when areas such as Orange County had relatively light demand for health care services. That formula has perpetuated disparities, despite dramatic increases in the number of poor and needy in the county, Bergeson said.

“Demographics have changed in Orange County,” said Bergeson, who sat on a legislative committee that hammered out the realignment compromise. “The needs have changed substantially.”

The proposed compromise would affect four health programs now funded by the state but administered by the counties: preventive health programs, such as immunization for measles; health services for people without Medi-Cal but too poor to pay for a doctor; mental health services, and payments for mental health hospital beds.

Cutbacks in state support for the programs have left counties underfunded and have helped produce a crisis that officials warn could drive the county into bankruptcy.

Faced with a huge shortfall of his own, Gov. Pete Wilson has proposed shifting responsibility for those programs to the local level. The realignment would relieve the state of $2.17 billion in programs and help it close the state’s $14.3-billion deficit.

In return, Wilson has proposed raising the statewide sales tax and boosting vehicle registration fees. Of the new money, $165 million would be earmarked for Orange and other suburban counties to make up for the historic inequities in their funding.