Countywide : Officials Lauded for Health-Care Efforts

In contrast to a contentious hearing last year, state Medi-Cal commissioners on Thursday lauded county supervisors and medical leaders for recent efforts to make health care accessible to the poor.

They were impressed with a program called MOMS, expected to start next year, that will recruit obstetricians to treat Medi-Cal patients, and a companion plan aimed at helping uninsured patients find a doctor.

The six members of the state Medical Assistance Commission, the agency that negotiates Medi-Cal contracts with hospitals, declined to explain what they would do to assist the two local health programs. But Chairman Eric Gold pledged: “We will do everything we can as a commission to help make them work.”

For all the progress in health care, serious problems remain, county officials and medical leaders testified. Among them:

* An “explosion” of Medi-Cal patients--due partly from new federal and state regulations that relax criteria for receiving government health coverage, and partly from a baby boom, especially among Latinos, county officials said.

* While the number of Medi-Cal patients is rising sharply, few local hospitals will treat them for anything but an emergency.

Hospitals here now see 42,000 Medi-Cal patients a month, up from 25,000 per month in 1988, said Russell Inglish, vice president of the Hospital Council of Southern California. But only nine hospitals still have full-service Medi-Cal contracts, compared to 17 hospitals in 1983.

* There may be a shortage of neonatal intensive care beds for critically ill Medi-Cal babies, Inglish said. Officials at three hospitals have complained of difficulty in finding beds for these patients.

* There is a shortage of physicians willing to back up the emergency department, Inglish said. Because Medi-Cal reimbursement is low, many doctors are not willing to remain on call for emergencies unless they get extra pay from their hospitals.

As the hearing ended, Gold sharply questioned Dr. Lawrence Kammerman, president of the Orange County Medical Assn. about doctors’ willingness to treat the poor.

Last year, Gold complained, OCMA’s president had testified about “great resistance” by Orange County doctors to Medi-Cal.

But, Kammerman argued, “I see islands, pockets of slight change in attitude.”