San Diego County government is providing $4.3 million to 19 area hospitals that are grappling with the rising costs of providing emergency medical services.

The Board of Supervisors on Tuesday unanimously voted to share money received from a national tobacco lawsuit settlement with the hospitals. The vote was part of an effort, spurred by the Sept. 11 attacks and subsequent anthrax scares, to improve the region's ability to respond to disasters and terrorism. "Emergency medical care in our region is dangerously insufficient," Supervisor Dianne Jacob said. The vote was welcomed by some. "It's clearly a very significant step in collaborations between the Board of Supervisors and the health-care community in general," said Steven Escoboza, president of the Healthcare Association of San Diego and Imperial Counties. Hospital executives have complained that increasing costs for health supplies and equipment, growing numbers of patient visits and the closing of emergency rooms has placed the region's emergency medical system at risk. In October, supervisors voted to spend $8.8 million to help the local medical system. Part of the money went toward upgrading a county computer system used by emergency medical workers. The rest was earmarked for new laboratory equipment to detect modes of bioterrorism. The board set aside an additional $6.3 million and asked staff to hold public meetings and talk to medical industry representatives to determine how that money should be used. That work resulted in the recommendation that the county provide $4.3 million to hospitals in the county that have licensed emergency rooms, including Palomar Medical Center, which reopened its trauma unit Tuesday following a two-week closure because of a labor dispute. Officials said the distribution of the tobacco litigation money had no bearing on the Palomar settlement. The other hospitals getting money are Alvarado, Children's, Fallbrook, Kaiser, Paradise Valley, Pomerado, Scripps Memorial Chula Vista, Scripps Memorial Encinitas, Scripps Memorial La Jolla, Scripps Mercy, Sharp Chula Vista, Sharp Coronado, Sharp Grossmont, Sharp Memorial, Tri-City Medical Center, UCSD Medical Center, UCSD Thornton and Villa View Community. The money will not be shared equally. It will be divided based on a state formula that takes into account the number of emergency room visits, licensed beds and amount of care not covered by insurance or the state. Hospitals will get anywhere from $40,000 to $1 million. Escoboza said the $4.3 million, along with the $8.8 million supervisors approved in October, will help the region's emergency system. Supervisors Chairman Ron Roberts cautioned hospital representatives not to expect more financial help from the county in the future. "I hope that all of those who are recipients of these funds also know that they they've got some work to do to get this system running right because these dollars are not going to be there in perpetuity," he said. Escoboza said the industry understands. "What they're trying to do is provide stopgap funding," he said. "This is just one-time funds. We need to do something very quickly for the long term."

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