Mandatory AIDS Testing Will Be Sought by State

The Deukmejian Administration called Friday for the power to require potential AIDS victims to undergo testing for the disease when there is a “compelling public health need.”

In releasing the findings of a long-awaited state study on AIDS, Kenneth Kizer, the state health director, also proposed that confidentiality requirements be loosened so that public health officials would be able in certain cases to obtain the names of individuals shown to have antibodies to the disease.

Kizer predicted that the number of cases in California will jump from 4,140 this year to 30,000 by the end of 1990, and that the cost of treating AIDS and AIDS-related diseases will pass the $5-billion mark by then.

To help combat acquired immune deficiency syndrome, Kizer proposed an increase of $8.4 million in state funds for research, public education and other programs during the 1986-87 fiscal year, beginning July 1. That would bring total state spending on AIDS during the next fiscal year to $26.6 million.

The health director’s proposals were promptly criticized by members of the health care community, who said mandatory testing is unnecessary, and by legislative leaders, who said the Deukmejian Administration study is inadequate and does not answer major health questions.

The Administration plan was the outgrowth of Gov. George Deukmejian’s promise in his annual State of the State speech in January “to fully fund our fight against that ruthless killer called AIDS.”

Kizer acknowledged that his proposal to require people to undergo testing for the presence of AIDS antibodies and his plan to loosen confidentiality requirements would be controversial. But he said both steps are needed if the state is going to bring the disease under control.

“We’re proposing, and we feel that it is very important, that there be some legislative change that would allow us to do mandatory testing for the virus when there is a compelling public health need to do so,” Kizer told reporters.

There is no test available to determine whether an individual has AIDS, but antibodies to the disease can be detected by a blood test. About 30% of those found to have the antibodies develop AIDS, Kizer said.

Those Who Would Be Tested

Kizer said he would ask the Legislature to allow mandatory tests for such people as rapists, the criminally insane, the mentally ill, the developmentally disabled and kidney dialysis patients.

Under his proposal, tests could also be required of residents in a community where a sudden increase in AIDS cases has been observed. It would be up to public health officials to determine when there was a “compelling public health need,” he said.

Health authorities already have the power to order people to undergo tests for other diseases, such as tuberculosis, he noted. The results of mandatory tests for AIDS antibodies would be confidential, he said.

“If we’re going to try to tackle this disease in the community, if you suddenly have a change in the community, you need to be able to interpret it,” he said. “In given circumstances, it might be important to know who’s exposed.”

Dr. Neil Schram, chairman of the Los Angeles City/County AIDS Task Force, said mandatory testing would violate the rights of citizens and provide no help in combatting the disease.

Loss of Civil Rights

“It should be obvious that mandatory testing of one individual requires that individual to give up his or her civil rights,” he said. “I’m not sure there is any evidence that mandatory testing will have any effect on this epidemic.”

Dr. Michael Roth, co-chairman of the state AIDS Commission, agreed, saying, “I can’t think of a compelling public health need that would be relevant for mandatory testing.”

Kizer’s proposal to loosen confidentiality laws would permit the state to obtain the names of individuals found to have antibodies to the AIDS virus when tested by a blood bank or other medical center.

Centers set up specifically to test for the presence of AIDS would not be affected, Kizer said. These centers guarantee anonymity to their patients.

Changing the confidentiality law, he said, would permit the state to investigate outbreaks of the disease in areas that are not considered to be high risk.

In California, Kizer said, about 92% of AIDS victims are male homosexuals or bisexuals. The state Health Services Department study found that there were AIDS cases in 37 of the state’s 58 counties, and Kizer said he expects the disease to spread statewide by 1990.

Brown ‘Disappointed’

The bulk of the $8.4-million increase in state funds would be spent on education to prevent the spread of the disease, beefing up monitoring of the spread of AIDS and research to find a vaccine or cure.

Assembly Speaker Willie Brown (D-San Francisco) said in a statement that he was “disappointed” with Kizer’s proposal, which Brown asserted was released seven months late.

Brown said that many of the specific proposals were recommended by the Legislature last year and rejected by Deukmejian. Furthermore, he said, the proposal does not address important health questions, such as how schools should deal with children who have AIDS and how the state should handle cases of AIDS-related complex (ARC), which often is a precursor to AIDS.

“What is most disappointing is how the plan fails to address the controversial public health questions where we had hoped the Administration might offer some guidance,” Brown said.