ORANGE COUNTY: Report Calls for Consolidated Indigent Services
An Orange County grand jury report issued yesterday recommends the immediate merger of the county's Medical Services for Indigents program with CalOptima, its managed care plan for the poor and disabled, charging that disadvantaged residents' emergency health needs are not being met. MSI -- the insurer of last resort -- draws on $42 million in mostly county funds to provide care for 26,377 people ages 21-64, but is limited to providing emergency care; CalOptima provides both preventive and emergency care to 200,000 residents with a combination of state and federal grants totalling $520 million. The Los Angeles Times reports that according to the grand jury report, the MSI program "needs to provide preventive and maintenance services, such as follow-up care, but can't without an increase in funds." The merger of the two programs has been long delayed because of funding disputes. The report also found that MSI's enrollment application can be "difficult and processing can be delayed," and that reimbursements often fall to the "inadequate" level of 50% or less. Jim Gilwee, spokesperson for the Healthcare Association of Southern California, said the report "does a good job at presenting an overview ... but it oversimplified the financial and structural differences between the two programs, and those differences make a quick merger difficult." CalOptima spokesperson Kathy Crowly said a merger would be "meaningless" without increased funding. The county Health Care Agency's Alyce Mastrianni said her department plans to file a response to the report by Sept. 2 (Mehta, 6/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.