Medical group gearing up for war over 911 phone tax.

THE California Medical Association is pressing ahead with its financial support of a November ballot initiative that would tax telephone and cell phone bills to fund emergency services around the state.

The doctors' group reiterated its support last week of the so-called 911 initiative, in spite of the recent decision by a major hospital industry trade group to pull out of the sponsoring coalition. The initiative faces a post-recall, anti-tax environment and strong opposition from telephone companies.

"We understand the opponents are going to spend vast sums of money, but we think that Californians will understand to receive lifesaving treatment is important to them," said Peter Warren, a CMA spokesman.

The 911 initiative would place a 3.7 percent surcharge on telephone bills, raising a projected $600 million that would help fund hospital emergency rooms and pay emergency physicians, as well as assist community clinics in providing care to relieve overcrowding in ERs.

The measure caps the tax at 50 cents on residential land lines, but has drawn stiff opposition from telephone companies, which are particularly opposed to the lack of caps on business lines and cell phone bills.

A group called Californians to Stop the Phone Tax has already drawn millions in contributions from carriers, including $1 million from AT&T Wireless Services Inc. and $5 million from SBC Communications Inc., parent of Pacific Bell and part owner of Cingular Wireless L.L.C.

By contrast, the Coalition to Preserve Emergency Care lost its biggest backer when the hospital trade group, the California Healthcare Association, pulled out in April, citing the opposition and lower-than-expected polling numbers. In its announcement of its continued support of the initiative, the CMA said it still needed to raise $300,000 to meet its fund-raising goal of $900,000.

Other members of the 911 coalition are the California Chapter of the American College of Emergency Physicians, the Emergency Nurses Association of California, California Professional Firefighters and the California Primary Care Association.

Holding Steady

Despite pressure from the hospital industry to alter a new nurse staffing law, state health regulators plan no immediate changes.

Hospital officials say the law is prompting more ambulances to be diverted from emergency rooms, as short-handed ERs reject incoming patients.

A state Department of Health Services spokesman said officials at this point are only +'monitoring" the effects of the law, which mandates specific nurse-to-patient ratios, including at least one nurse to every four emergency room patients.

"It is now less than four months since the regulations took effect (Jan. 1), and we believe it is too soon to start drawing conclusions and making policy change decisions," said department spokesman Robert Miller, in an e-mail.

A survey being conducted by the hospital 2industry shows emergency room diversions are up more than one-third statewide.

In Los Angeles County, data provided by the Emergency Medical Services Agency shows that 33 percent of all ambulances were diverted during the first three months of the year, compared with 26.7 percent in the like period a year earlier.

The California Nurses Association opposes any changes to the law, contending it leads to better care for emergency room patients, even if it means sending them to other hospitals.

In Charge

UCLA Hospital Systems has a new chief following the departure of Dr. Michael Karpf, who left amid questions about the financial stability of the facilities he oversaw.

Dr. David L. Callender has been appointed associate vice chancellor of the system and director of UCLA Medical Center, which includes three hospitals and 18 primary care clinics. Callender most recently was executive vice president and chief operating officer at the University of Texas MD Anderson Cancer Center.

Karpf left UCLA in September to take a top position at the University of Kentucky's medical center after an outside consulting firm found deep financial problems at the vaunted UCLA system. The university is now in the midst of cutting hundreds of jobs over the next three years in an effort to save $31 million.

Staff reporter Laurence Darmiento can be reached at [phone] ext. 237 or at [e-mail].