Governor Rejects Call for State of Emergency to Help Combat AIDS

Gov. George Deukmejian has rejected a proposal by five leading public health experts that he and the Legislature declare a state of emergency in California in order to help finance the fight against the growing AIDS epidemic.

The five experts, acting as advisers to a nonprofit organization created with state and private funds to formulate a comprehensive AIDS plan for California, also recommended that the state set up a centralized program that would fill existing “gaps” in treatment and prevention programs.

Specifically, they recommended an annual $70-million statewide educational and behavioral modification program aimed at groups at high-risk of AIDS infection, such as homosexuals and intravenous drug users, as well as teen-agers, minority populations and prostitutes.

The key recommendations, to be unveiled at a Los Angeles press conference today, include:

- The creation of regional treatment and evaluation centers throughout the state to coordinate the management of acquired immune deficiency syndrome cases from diagnosis to death.

- The creation of programs that would enable people attending family planning and sexually transmitted disease clinics, as well as pregnant women and people seeking marriage licenses, to undergo a blood test for exposure to the AIDS virus. Now, according to the health advisers, few counties offer such programs.

- Expansion of the additional blood-testing centers so that anyone seeking an AIDS antibody test can get one within 10 days.

But even before these recommendations were made public, Administration officials reacted negatively to them.

“The governor is not expected to proclaim a state of emergency for AIDS in the face of the record commitment we are making in the fight against AIDS,” said Kevin Brett, Deukmejian’s press secretary.

Brett said the “governor does recognize AIDS as a most severe public health threat.” The $32.1 million that Deukmejian has proposed for the coming fiscal year, he said, exceeds the combined AIDS budgets of the 10 other states with the largest AIDS caseloads.

The governor had not yet been briefed on the recommendations but senior officials of state Health and Welfare Agency and Department of Health Services were.

Ed Mendoza, assistant deputy director for public health at the Department of Health Services, said a major problem with coordinating government funding is that “at this point we don’t know what the federal government plans, so coordination would be difficult.” He said coordination is already taking place between the state and counties.

Mendoza was also skeptical of the plan to coordinate patient care at regional centers because the full spectrum of medical and social services are not available to all AIDS patients in most places.

130 Experts Consulted

The five experts who advised the Health Policy and Research Foundation consulted with more than 130 experts before making their recommendations. They said it is “essential” to coordinate the funding as well as the spending of monies to combat AIDS.

The advisers are Dr. James Chin, former chief of infectious diseases for the state Department of Health Services who now is working for the World Health Organization; Dr. Donald Francis, the Centers for Disease Control representative in California; Dr. Michael Gottlieb, a former UCLA AIDS expert; Dr. Alan McCutchan, University of California, San Diego, AIDS coordinator, and Dr. Warren Winkelstein, former dean of the School of Public Health at the University of California, Berkeley.

Their recommendations, contained in a 75-page report, are based on the predictions made last year by the Institute of Medicine and the U.S. Public Health Service on the number of AIDS cases by 1991. They are also intended to supply the public health priorities in order to implement a proposal pending in the Legislature by Assemblyman Art Agnos (D-San Francisco), a leading gay rights supporter.

The five advisers intend to ask Deukmejian and the Legislature to call a “summit meeting” of all prospective funding agencies--government and private--in order to establish the public-private partnership that the advisers say will be needed to “survive the crisis,” according to Bruce Decker, who is Deukmejian’s appointee as chairman of the state AIDS Advisory Committee. He said he endorses the recommendations.

Decker is the founder of the Health Policy and Research Foundation and has been an outspoken critic of the state’s efforts to combat AIDS.

‘Crisis Management’

“The problem now,” he said, “is that most organizations that are focusing on AIDS are so mired down in crisis management that they can’t look ahead.

“The state looks at budgets only year-to-year and it can’t look more than one year ahead, Decker said. “Continuing to pay lip service to AIDS will inevitably lead to fiscal and ethical chaos. If we do not stop transmission of the virus, tens of thousands of Californians will die of AIDS in the next decade--at a cost of hundreds of millions of dollars, not counting the loss of social services and productivity.”

Declaring a state of emergency would be one way to circumvent the state’s constitutional limit on spending. Known as the Gann limit, the curb places a cap on the amount of money that state and local governments may spend each year. During the fiscal year that begins July 1, the governor’s proposed $39.3-billion budget will come within $80 million of the limit.

In their recommendations, the advisers called on Sacramento to increase annual state spending on AIDS from $30 million to $50 million.

The health advisers estimated that the cost of treating the 5,370 people with AIDS or the so-called AIDS Related Complex this year will total about $200 million.

Times staff writer Richard C. Paddock in Sacramento also contributed to this story.