NORTH COUNTY -- A few dozen wary North County health-care leaders told San Diego County officials Monday that they were happy to help in a $615,000 study of the region's "health safety net," but wondered what the county hoped to accomplish with the study and whether supervisors were thinking of chipping in more cash to support that safety net.

County health officials and members of an emergency medical services consulting group held two meetings in North County on Monday to brief hospital, doctor and community clinic leaders on how the six-month study would be conducted.

The general purpose of the study, according to the county's director of health and human services, Jean Shepard, is to detail what kinds of medical services are available in the county, where and how they're delivered, what "gaps" exist, and how to make sure the system will be sufficient to handle the county's growing population in the coming decades.

Shepard and members of the consulting group said Monday that they intend to create the study by reviewing 35 previous health-care studies done about the region in recent years, interviewing people who actually use health-care services, health-care providers themselves, and getting feedback from the public later this summer.

County supervisors actually ordered the study be done more than a year ago -- after being angered by a UCSD Medical Center plan to close its Hillcrest hospital and move its beds and trauma center to La Jolla in 15 to 20 years.

Supervisors Ron Roberts and Greg Cox said then UCSD's plan, among other things, could hurt the chances for the poor who live south of Interstate 8 to get hospital care.

On Monday, health officials at the San Marcos meeting said the UCSD plan could weaken the region's "health safety net" --- the system of services and providers who make sure the poor, the uninsured, and under-insured receive health-care.

Health-care leaders said weakening the safety net could hurt all San Diegans -- rich or poor, because:

- Taxpayers pick up the costs of uninsured patients through the services offered in the safety net.

- Uninsured and underinsured people who go without health care could become public health risks. Children without immunizations could make other children, and their parents, sick. And unhealthy people working in "sensitive" industries, such as restaurants and the food industry, could pass along illnesses.

Despite all that, hospital, clinic and other health-care leaders who attended Monday's meetings wondered about the county's involvement, and what it hoped to accomplish.

Unlike many other counties in California, San Diego County is only tangentially involved in the region's safety net. The county does not directly provide health care to the poor through its own hospitals. And although it does pay for some care for the poor by reimbursing private hospitals, the county has largely left the health care safety net's management and costs to private hospitals, doctors and clinics.

Because of that, Shepard acknowledged Monday that the county had no authority to "order anybody to do anything," and health leaders from around North County wondered what purpose the study would serve.

Physician Nick Yphantides said health officials in San Diego County had already "done lots of studies" that had largely been ignored.

He said it was time someone offered solutions to the problems plaguing health care -- lack of funding, increasing state and federal mandates to provide care, and the large number of uninsured and immigrant populations.

"I think the study idea is good," Yphantides, a former member of the board of North County's largest public hospital district, Palomar Pomerado Health, said. "But we have done lots of diagnosis. It's time for somebody to stand up and write a prescription, do a surgery, and pull the trigger."

One woman asked if supervisors were looking for ways to come up with county funding to fill health-care service gaps.

Shepard replied by saying that she did not want to predict what kinds of recommendations the report might make when a first draft is completed in June.

But she said she hoped the recommendations "would be broader, and not just about needing to infuse more money into the system."

Tracy Ream, executive director of the nonprofit Neighborhood Healthcare, which runs four community clinics in Escondido and one in Pauma Valley, also said she hoped the study would provide solutions and not be discarded once it was finished.

"Something that we could get our hands around, and we don't end up saying, 'Great, there was an expensive study, and it was presented to the county supervisors. And here we are, right where we were.'"

Shepard and Mike Williams of the Abaris Group, the consulting group that will conduct the study, said they hope to have a draft complete with recommendations for health-care officials and the public to comment on in June. A completed plan taking public input into account could be finished in the fall.

Shepard said before the afternoon meeting in San Marcos that health-care leaders had been very supportive of the county's involvement.

"They're very clear that we're in a partnership," she said. "They're very well aware of that and want to come to the table and work with us. They know we can't order them to do anything, but they also know that this is a system where we all depend upon one another."

Contact staff writer Gig Conaughton at (760) 739-6696 or gconaughton@nctimes.com. To comment, go to nctimes.com.