Health Officials Hit for Inaction on AIDS Care

The county Commission on AIDS admonished Los Angeles County health officials Friday for failing to move quickly on home and hospice care for dying AIDS patients and proposed a March 1 deadline to begin spending $1.5 million in untapped funds.

Supervisor Mike Antonovich, whose appointee to the commission urged the fast-track approach, said later in the day that he will champion the proposal when it comes before the Board of Supervisors.

At an emotional meeting that included testimony from dying patients, the county Department of Health Services was criticized for failing to spend any of the money approved by the Board of Supervisors last July for alternative AIDS care.

A 37-year-old Los Angeles man who is dying of AIDS urged the commission to “seize the moment” so that when he dies it will be “at home in the arms of my loved ones or in a facility where they can be with me.”

The vote, widely hailed by AIDS organizations, including AIDS Project Los Angeles, came after Dr. Monroe Richman, Antonovich’s appointee, told the commission that the current approach to AIDS care is not working.

“We need to break the mold of acute hospital care that the county relies upon today,” Richman said after the meeting. “It’s far better and less costly to have someone at home than in a remote hospital.”

A top aide to Antonovich, Victoria Fouce, said that Richman sought the March 1 deadline “with Mike’s full knowledge” and that Antonovich intends to support the proposal when it comes before the board.

The commission called for a wide spectrum of care, including more hospice facilities, day-care facilities to take the burden off of families for several hours each day, home nursing, home attendants for those who are not extremely sick and more clinic-oriented care for patients who are still able to get around.

AIDS health care experts nationally agree that hospital care is by far the most expensive and often the least appropriate way to deal with AIDS patients.

The national average cost of daily hospital care is $800, compared to $200 for 24-hour home care and about $80 a day for home attendants for those who need no medical treatment.

Commissioner Gary Fowler echoed the criticisms of many at the meeting, saying he was “astounded” that money approved by the Board of Supervisors in July still had not been spent.

Several county officials attributed the long delay to the county’s cumbersome requirements when seeking outside health contractors and said they are still awaiting a study, not due until February, that will show the county what kinds of alternative care are needed most.

In addition, several officials in the county health department said county Health Services Director Robert Gates did not grant his department the permission to spend the money until September.

Dr. Martin Finn, medical director of the county’s AIDS Program office, said that if the Board of Supervisors approves the commission’s recommendation, “we will have to move faster.”