Ventura County's private and nonprofit hospitals are planning to use their $900,000 share of tobacco settlement money to pay for seismic retrofits on aging facilities and to help cover the cost of providing health care to uninsured patients.

Under an agreement that the Board of Supervisors is expected to approve today, each of the seven hospitals would receive up to $90,000 for securing boilers, ventilation equipment and other fixtures that could come crashing down during an earthquake. The hospitals are also entitled to recoup the costs of treating uninsured patients who arrive in emergency rooms. Total compensation available to each hospital varies, from $163,000 for St. John's Regional Medical Center in Oxnard to $98,000 for Los Robles Regional Medical Center in Thousand Oaks. Distribution amounts are higher in hospitals that historically serve more poor patients and therefore have higher costs that are not reimbursed, said county spokeswoman Norma Camacho. Santa Paula Memorial Hospital is eligible for up to $135,000; St. John's Pleasant Valley in Camarillo, $136,000; Community Memorial in Ventura, $135,000; Simi Valley Hospital, $123,000; and Ojai Valley Community, $98,000. An advisory committee agreed to provide each hospital with $90,000 for seismic retrofit work because hospital administrators have said it is a pressing need, Camacho said. Hospitals are under the gun to meet a series of deadlines imposed by the state for upgrading facilities to withstand a major earthquake. The first deadline--for bolting down dangerous equipment--was in December. It cost $172,000 to complete that work at St. John's Pleasant Valley Hospital in Camarillo, said Mike Murray, the hospital's administrator. But St. John's Regional Medical Center in Oxnard, also owned by Catholic Healthcare West, spent nothing on upgrades because the facilities were built with the safety measure in place, Murray said. Still, money is needed to prepare for a second round of more costly structural improvements that must be completed by 2008, he said. He estimates it will cost $16 million to upgrade the Camarillo hospital alone. "We've got some major funding challenges down the road," he said. If hospitals don't spend all of the $90,000 on seismic retrofits, they can use the rest to help provide medical treatment to patients who cannot pay, Camacho said. Although the reimbursement rates are generally lower than those paid by Medi-Cal and Medicare, hospital administrators say they will jump at the chance to get at least some of their uninsured costs covered. "There is clearly a need for any help we can get," said Mark Gregson, chief executive officer of Santa Paula Memorial Hospital. "Health care revenue is not keeping pace with health care costs, and that's particularly true for small hospitals. We are still in a precarious position." Murray said the St. John's hospital in Oxnard logged 45,000 visits to the emergency room last year--and that number is expected to grow. Meanwhile, more people are uninsured because they have lost a job in the nation's unsettled economy, he said. "The amount available to do true charity care becomes more of a pressure," Murray said. "We can't turn people way. It's our responsibility to serve them and it's part of our mission. So any additional assistance we can get from the county, it's needed and appropriate," he said. The money flows from county government's $10-million annual share of the states' lawsuit settlement with major tobacco manufacturers.

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