County Establishes Panel, Coordinator Post to Fight AIDS

The Board of Supervisors on Tuesday established a committee to plan Orange County’s battle against AIDS and created a new position to coordinate public and private efforts to serve patients and prevent the spread of the deadly disease.

In accepting the county report titled “AIDS Master Plan,” the supervisors also agreed to search for money to finance what was identified as a pressing county need--nursing home and other long-term care for AIDS patients well enough to leave the hospital but too ill to live alone.

“This won’t solve the AIDS crisis in Orange County,” said Supervisor Harriett M. Wieder, who requested the master plan’s development nine months ago. “But this does give us a direction to follow. It serves as a road map and enables us to focus our attention on the most pressing needs.”

Criticism of Report

Community groups serving people with AIDS or at risk from the disease have been mildly critical of the report, saying it described the current status of services but did not advocate bold new efforts.

However, Supervisor Thomas F. Riley added his own recommendation, that the county create the position of AIDS coordinator, who will work with the advisory committee and serve as a liaison with the community.

With the exception of establishing the new position, the supervisors on Tuesday did not pledge additional money for the fight against AIDS. But financial assistance to the hard-pressed, nonprofit community groups dealing with AIDS should be one of the goals of the advisory committee, said a spokeswoman for a coalition of service organizations.

Still, Pearl Jemison-Smith, president of Action or AIDS Coalition to Identify Orange County’s Needs, said she was pleased with the supervisors’ action.

“Money isn’t everything. Coordination is more,” Jemison-Smith said. “It would have been nice to see dollars and cents, but we’ve got the committee. We’re demonstrating today that AIDS groups are coordinated and working with the system to get things done.”

Acquired immune deficiency syndrome is caused by a virus that attacks the body’s immune system, leaving it defenseless against disease. The virus is spread through sexual contact, hypodermic needles and the exchange of tainted blood or blood products. In Orange County, 90% of the AIDS patients are homosexual or bisexual, according to the report.

Although intravenous drug users make up only 2.5% of the AIDS cases to date, the county has planned an education campaign in the drug community because addicts pose a major risk in spreading the disease to the larger heterosexual community, county health officials have said. Infected drug users can spread the virus to their sexual partners, who can in turn spread it to other adults through sexual contact, or to children through childbirth, officials have said.

Using data from the U.S. Centers for Disease Control, Action estimates that Orange County will have had 1,425 AIDS cases by 1990, 600 of whom will still be alive. About 800 cases of AIDS-Related Complex--itself a devastating illness, which often precurses AIDS--will have been reported by then. The figures do not include the unestimated numbers of symptom-free people who will have been infected with the virus and could transmit the disease.

“We are currently experiencing the epidemic of the century, and the need for a cooperative planning effort at this time is critical,” Jemison-Smith told the supervisors.

Areas of Need Identified

Action identified 13 “areas of need” that the AIDS advisory committee should address. They include education beginning in elementary school, creation of outpatient facilities for diagnosing and treating AIDS, development of mental health programs and the financing of nonprofit community organizations that help fight the disease.

Larry Stahl, UCI Medical Center assistant director, underscored Action’s call for assurance that AIDS patients will have “state-of-the-art, cost-effective” acute care available in the future.

UCI Medical Center treats about 40% of the county’s AIDS patients, he said. Although the hospital can handle the AIDS patient load, which averages about eight daily, “we won’t be able to continue” if the disease spreads as predicted, he said. Not only is the hospital financially burdened--most AIDS patients are on Medi-Cal, which does not fully pay for the cost of care--but the hospital beds are also needed by patients with other ailments, he said.

Teaching Mission

“Our No. 1 mission is teaching. That might be threatened if we take every AIDS patient” and have to exclude other patients who should be seen by the medical staff and doctors-in-training, Stahl said after the meeting.

Stahl does not foresee the establishment of an “AIDS unit” at the medical center but said faculty members are willing to “provide expertise” to physicians at other hospitals.

One problem, according to the AIDS master plan, is the dearth of nursing home beds for AIDS patients who are ready to be discharged from the hospital but have no place to go for ongoing care. Nursing homes do not accept AIDS patients because Medi-Cal pays only a fraction of their costs, according to the report.

The AIDS planning committee will be composed of representatives from the county health care and social services agencies, community organizations, institutions that serve AIDS patients and professional associations, according to the county report. The county public health officer, Dr. L. Rex Ehling, will report back to the supervisors in 60 days with the committee’s membership.

At the same time, the public health officer is expected to report on funding the new position of AIDS coordinator.

The supervisors created the new position and committee with a caution.

“All the things we do, do not supplant personal responsibility,” said Supervisor Bruce Nestande.

One member of the public went further. The Rev. Louis P. Sheldon, representing the Traditional Values Coalition, said in a written statement to the board that mass testing may be necessary.

Hospital patients, pregnant women, all inmates in jails and prisons and couples about to marry should be tested, he said.