Use Tobacco Cash on Health, O.C. Board Told

Health-care advocates confronted Orange County supervisors Wednesday demanding that $912 million from the nationwide tobacco settlement be earmarked for local health care--not more jail beds or early debt payments, as other county officials propose.

By the end of a workshop that drew more than 100 people to a Costa Mesa neighborhood center, most supervisors were willing to consider applying some of the windfall to health-care programs.

But Supervisor Jim Silva remained focused on using the money to reduce the county’s bankruptcy debt.

“The bottom line is, we have a legal obligation to make sure that the debt’s paid off,” Silva said.

Orange County stands alone among neighboring cities and counties in planning to spend the tobacco money, use of which is unrestricted, on programs unrelated to health care, even though a poll released Wednesday shows that 81.6% of county voters favor designating the funds for public health.

Residents who spoke at Wednesday’s workshop were passionate that the money, awarded for harm done to public health, should be spent on improving care for all county residents.

“Although we need more beds in jails, there are more people in beds in this county sick from illnesses,” said Paulette L. Motzko, who was diagnosed with epilepsy at age 9.

Motzko said she took three buses from her home in Orange to attend the meeting and voice her opinions. “It was critical that I be here,” she said.

Dennis Clark of Costa Mesa said he was saddened to be pitting “law enforcement with health care.” For Clark, speaking out served as solace after the death of his 61-year-old brother from lung cancer.

“My brother, Michael, who smoked two packs of cigarettes a day, died last year,” said Clark, president of the Health Care Council of Orange County. “I wanted supervisors to please pay attention to people like me and give us as much credibility as those county staff members who had the advantage of tremendous resources, such as the slide shows and computers,” he said.

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By the end of the daylong session, supervisors were talking about using at least some of the money for health-care programs.

“They were very well-organized,” Silva said of the public-health advocates as the meeting wound down. Silva, who has been the most ardent supporter of using windfalls to pay off the county’s debt, said the public testimony was compelling.

Board Chairman Charles V. Smith said there should be enough money for a variety of uses.

“This thing is not going to be all health care, all jails, and it’s not going to be all debt reduction,” Smith said. “It’s very obvious. We need a coordinated plan that addresses all three issues. There is enough money available to address all of these issues.”

Supervisor Cynthia Coad said she understands why the county needs to pay off its debt and save millions in interest payments, but she said she also prefers spending on items like community health clinics.

County officials had said earlier that they hope to use the windfall from the tobacco industry, to be paid out over 25 years, mainly for jail expansion and debt reduction. By paying down debts early, county executives had hoped to free up $23 million to $28 million a year in general fund money that otherwise would have gone to interest payments.

Gary Burton, the county’s chief financial officer, said he will meet individually with supervisors to develop alternatives for them to consider. His hope, he said, is to make recommendations for the board to consider at its Nov. 9 meeting.

Early in Wednesday’s budget workshop, Sheriff-Coroner Michael Carona reminded supervisors about a 21-year-old federal court order that held the county in contempt because of inmate overcrowding at its jails.

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Since 1986, when the county initiated an early release program, more than 500,000 criminals have been freed early or simply cited and released.

“It’s not an issue of ‘If we build them, the inmates will come,’ ” Carona said. “They’re here now. We are just releasing them.”

Despite ongoing construction projects, the county remains 2,532 jail beds short, Carona said in urging supervisors to use tobacco funds for more jail construction. Part of the money allocated for jails would have a health-care use by paying for drug and alcohol treatment for inmates, he said.

To finance a jail and also free up more revenue, Burton proposed a way to leverage part of the funds through a nonprofit agency. The agency would sell bonds tied to the tobacco settlement and use the proceeds to help pay for jail expansion and reduce part of the bankruptcy debt.

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State Sen. Joe Dunn (D-Santa Ana), who has been involved in the tobacco settlement at the state level, told supervisors that they already had lost out on more tobacco money because they did not sue the tobacco industry. He urged them to spend settlement money on health care and not “lose yet another opportunity.”

“In 25 years we will be paying for tobacco-related illnesses, so what’s really the best long-term investment?” Dunn asked. “It’s health care. We must attempt to minimize those costs now and attempt to avoid billions of dollars in losses later.”

The poll released Wednesday was commissioned by a new Orange County coalition called the Health Alliance to Reinvest the Tobacco Settlement. It surveyed 505 residents in early October and found that only 6.5% want the tobacco settlement funds to go to other programs, such as education. About 5% thought the money could be spent on both health care and other programs. The rest had no opinion.

The alliance comprises doctors and hospital trade groups, the county’s heart, lung and cancer associations, the United Way, the Catholic Diocese of Orange, the League of Women Voters, the American Assn. of Retired Persons and prominent local businesses, among them C.J. Segerstrom & Sons and Rainbow Disposal.

“This is an unusual coalition,” said Sam Roth, spokesman for the Orange County Medical Assn. “Its members believe that a healthy work force is important.”

The idea that the county would spend its tobacco windfall on anything other than health care or smoking prevention “is particularly galling to physicians,” who are partially subsidizing health care to the poor and uninsured because there is no county hospital to take in such patients, Roth said.

The county’s payment for those patients at medical facilities does not cover the cost of care, he said. “The county would be spending tens of millions of dollars more on health care if it had a county hospital.”

In contrast to Orange County, neighboring San Diego County has pledged to spend its share of funds directly on health care or on programs that benefit public health. Los Angeles County, which will receive a total of $3.4 billion, is planning to replace County-USC Medical Center, while the city of Los Angeles will spend most of its tobacco settlement on health needs, including anti-smoking education programs and wheelchair curb cuts to aid the disabled.

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Times staff writer Seema Mehta contributed to this report.