The Stanislaus County grand jury sided mostly with the county Health Services Agency in a dispute with physicians at Doctors Medical Center.

The grand jury said the county does not have to cover the cost when its clinic patients go to Doctors emergency room but cannot pay the bills.

California Emergency Physicians, whose members work in the Doctors emergency room under a contract with the Modesto hospital, claimed that the county owes it $659,352 for care for nonpaying patients.

The dispute stems from the agreement under which Doctors took over services from county-owned Stanislaus Medical Center, formerly Scenic General Hospital, when it closed in 1997.

Under the agreement, the grand jury said, the county has to cover the cost of nonpaying patients when they are kept overnight at Doctors, but not when they are seen only in the emergency room.

"The county has never paid for, nor is it obligated to pay for, emergency services for (medically indigent) patients," the grand jury said in a report released late Friday.

The report suggested that the physicians group seek reimbursement from the hospital. It said that in 1997, the hospital's chief executive officer "stated publicly at a Stanislaus County Board of Supervisors meeting that (Doctors) would cover all costs related to ER services."

The grand jury also urged the physicians to try to tap a state fund for care of low-income people.

Dr. Robert Donovan, who oversees the emergency room and said he filed the complaint with the grand jury, said Monday that he had not read the report and could not comment in detail.

Reagan Wilson, the county's chief executive officer, said the 1997 contract clearly says the county does not have to pay for emergency care at Doctors.

Tim Joslin, the hospital's chief executive officer, declined to comment because he had not read the report.

The hospital bills emergency patients for use of beds, equipment and supplies. The physicians group bills them separately for its services.

The report noted that state law bars hospitals from refusing emergency care to people who lack insurance or other means of paying for it.

The complaint to the grand jury included a claim that the staff at the county urgent care clinic was telling uninsured people to "go to Doctors ER; they will treat you for free."

The report did not explore this claim. It did say the county should increase efforts to get people to use its clinics, rather than emergency rooms, for problems that do not need immediate attention.

The county could do this with extended hours at the clinics, publicity about their services, revival of meetings between county and hospital officials, and increased enrollment in health coverage for low-income people, the report said.

"We have active, ongoing programs in that regard all the time," Wilson said, "and this is standing (Board of Supervisors) policy."

The Health Services Agency is required to respond to the report in writing within 90 days.

Bee staff writer John Holland can be reached at 578-2385 or jholland@modbee.com.

Reprinted by permission of Modesto Bee.