The Los Angeles County Commission on AIDS, with a forceful and constructive assertion of leadership in the county's lagging response to the deadly disease, has validated the wisdom of the Board of Supervisors in creating the commission last summer.
Under resolutions of the commission:
--There will be an emergency meeting within two weeks, if the supervisors agree, among commission members, chief deputies of each of the supervisors and leaders of the County Department of Health Services to examine the slow implementation of programs and the lingering risk of a crippling AIDS budget deficit.
--A deadline of March 1 will be established, if the supervisors concur, to implement the $1.5-million program budgeted for this year to provide expanded alternatives to in-hospital care for AIDS patients.
Impetus for the action appears to have been a study by the AIDS Hospice Planning Commission under the chairmanship of Michael Weinstein. The study underscored the importance of providing a variety of alternative-care programs at all stages of AIDS treatment, but particularly in the terminal months of life. The study also pointed out the inadequacy of existing programs even under this year's greatly expanded county budget. Alternative care has been the cornerstone of the AIDS program in San Francisco, the most effective program now operating, and has proved both cost-effective as well as more humane in most cases.
The urgency of action was brought home to the commission by a series of witnesses, including an AIDS patient, a registered nurse working in the San Francisco's Coming Home hospice who himself has an AIDS-related-complex infection, and two mothers who had cared for their AIDS-infected sons in their last months of life.
"You find a way for me to die at home in the arms of my loved ones or a facility in which my loved ones can care for me in dignity," Chris Brownlie, who told the commission he has AIDS, demanded. At present there is only limited home care in Los Angeles County, no long-term nursing home care, and only two small residential units for those with AIDS. And the county has not yet expended any of the $1.5 million for alternative-care programs in the budget for the fiscal year that began July 1.
"The Department of Health Services has to be made to act," Dr. Monroe Richman, a commission member, asserted. It was on his initiative that March 1 was proposed as deadline for action. Gary Fowler, another commission member, followed up with the motion calling for an emergency meeting with Robert C. Gates, director of county health, and chief deputies of each supervisor to find out what has happened.
This year's county budget of $38 million for the AIDS program faces a shortfall of at least $5 million in funding. Of the total, the county provides $9.2 million, with the balance funded by state and federal grants.
"What kind of games are we playing?" Rabbi Allen Freehling, chairman of the commission, asked. He then emphasized a new role for the commission: Pressing for a major increase in funding for the fiscal year commencing next July 1. It was the same priority identified more than a year ago by the County-City Task Force that the commission succeeded. But a new mood appears to have developed on the Board of Supervisors. Several members, including some who had resisted earlier appeals for more urgent action, quickly endorsed the two calls for action issued by the commission. That commitment is most welcome.