Dozens Vie for Proposition 10 Panel

Finding enough people to serve on civic commissions can often be a colossal task. But the line is out the proverbial door for those who want a seat on the coveted commission created by the tobacco-related Proposition 10.

The reason: money. Lots of it. The nine-member county commission will be in charge of spending an estimated $50 million--more money than most city councils oversee.

In a frenzied race, health care advocates and others throughout Orange County are pushing to get their nominees picked for what promises to be a powerful commission.

“Everybody’s been contacting us,” said Paul Hernandez, Supervisor Todd Spitzer’s chief of staff. “It seems everyone has a candidate.”

From the influential medical and hospital associations to the county’s small, nonprofit clinics, 66 candidates are seeking six openings on the local Proposition 10 commission. The candidates represent vocal constituents, many with strong political ties.

In the first full year of Proposition 10 taxes, about $690 million is expected to be raised statewide for early childhood development programs. Orange County’s share is estimated at $50 million, which is more than the county allocates to its Health Care Agency.

The commission will be in charge of spending $3 million to $6 million a month, worrying critics that it will get bogged down in politics and will allocate very little money toward the health needs of children.

Already, $606,000 has been put into a special account to establish the local commission. But the money may be used to hire a consultant to help guide commission members through a 12-month strategic plan process. Additional funds will be released once the plan is completed and submitted to the state.

Art Montez, a Latino community leader in Santa Ana, said he mistrusts the county’s elected officials, citing the board’s reduction of Health Care Agency expenditures in recent years from $48 million to $23 million.

“They’ve cut the budget by more than one-half, and have you seen anybody screaming about it?” Montez said. “There’s a lack of moral and ethical judgment here, in my opinion.”

Critics argue that because the county has no public hospital and ranks low among other counties in health care expenditures, it has created a health care crisis by limiting available services to those who need help the most.

“The county has the legal mandate, the responsibility, but they have no hospital, so they parcel out contracts to community-based health clinics,” said Rolando Castillo, chief executive officer of a consortium of Latin-American physicians.

Therefore, say Castillo and Montez, a potential conflict of interest would crop up should a member of a county-funded community health clinic win a seat on the commission.

“Who’s going to be the advocate for the underclass?” Montez said. “We need people on the commission who are not accountable to their political masters but to the public. People who are not drawing a paycheck from such a special interest.”

‘Integral Part of Safety Net’

But Martha Earlebaugh-Gordon, executive director for the Coalition of Orange County Community Clinics, said the commission must have members from the county-funded community organizations, despite what critics think.

“When people sit on the Proposition 10 commission,” Earlebaugh-Gordon said, “it’s really important that they understand that the community-based organizations and free clinics here are an integral part of the safety net.”

State law mandates that three seats be filled by a supervisor, in this case, the board’s chairman, and directors of the county’s Health Care Agency and its Social Services Agency.

The remaining four supervisors will each pick a candidate from one of four community groups: child care, community-based organizations, education and the medical community. The entire board will select the remaining two at-large seats.

Supervisors have scheduled interviews with candidates soon. Appointments are expected to be made by early June.

The backgrounds of the applicants--from educators to child psychologists--vary widely, and supervisors said they consider the nominating process more of a health issue than a political one. They said they are seeking top-flight candidates and will fight efforts to create another bureaucracy.

The proposition, which imposes a cigarette tax of 50 cents per pack, calls for spending on childhood development programs from prenatal stages to age 5.

The commission will be a policymaking body, said the county board’s chairman, Charles V. Smith. It will likely appoint people remaining from the pool of 66 applicants to fill vacancies on advisory committees, which would make recommendations on services and programs.

“It’s very difficult to keep it out of the realm of politics, but we’re trying to get qualified people to sit on this board,” Smith said.

But the issue Montez wanted to underscore was access. For too long, he said, the county’s Latinos and other minorities have been excluded from health care and the decision-making process.

High teen birth rates, diabetes and poor county health programs have chronically plagued the Latino community, he said.

“I think it’s all due to public policy and a lack of influence [on] the governing body,” he said.

A recent county health assessment, for instance, underscores Montez’s claims. Among adults, 17%, or about 335,000 people, have no health insurance--and almost 52% of those adults are Latino or Vietnamese. Additionally, about 90,000 children, or 13% of the county’s youth, have no health coverage--and 57% of those teens are Latino, the survey found.

Affordable Child Care, Parenting Classes

But a lack of insurance doesn’t tell the whole story. The working poor often receive little or no benefits under government programs, said Mary Paul, chairwoman for Latino Health Access, a Santa Ana health clinic.

Although health care is important, Paul argued that the intent of Proposition 10, sponsored by actor-director Rob Reiner, also covers affordable child care and parent-training programs. Both are significant for childhood development, she said.

“As a result of Medicare reform, thousands of children lost access to Medicaid because of confusion about benefits by case workers,” Paul said.

“I think the primary focus that Rob Reiner had was early development in programs like Head Start. The program still exists, though it’s not widespread in Orange County,” she said. “Babies’ brain development, they have learned, is tied to early stimulus and a nurturing environment.”

Differing Views Over Panel’s Mandate

Despite living in an affluent county, children without health insurance and proper care are at risk, said Kimberly Cripe, president of Children’s Hospital of Orange County in Orange.

Cripe, who is among the commission candidates, said she envisions the commission being involved in health prevention and wellness care for children, parental substance abuse, immunization and parent training.

Others, such as Earlebaugh-Gordon, believe the commission’s strategic plan should have “simple solutions” that build on existing programs instead of “reinventing new ones.”

Achieving a balance will be the commission’s challenge, especially when trying to keep politics out of the picture.

Spitzer said the board was very concerned when county staff first proposed a commission of only five members. It would have produced a commission majority with bureaucrats, he said.

“There was a lot of concern that [selection] would be a political decision,” Spitzer said. “I believe that we’re going to have such a high-caliber group of commissioners being recommended, and they will be well-respected individuals in the community and are either regionally or nationally known experts in their fields.

“Politics won’t even become an issue,” he said.

It shouldn’t, says Ronald DiLuigi, regional vice president of St. Joseph Hospital health system in Orange.

The board must realize, he said, that Proposition 10 “is not a brown or white issue, and it’s not simply health care. It’s a children’s issue.”