AIDS: Progress and Neglect

There is encouraging progress in Los Angeles County to fill the shortage of hospice services to those dying of acquired immune deficiency syndrome--AIDS. But the advances that have been made also measure some other critical problems that continue to be neglected.

The most recent announcements of importance are from:

--The Los Angeles County Department of Health Services, which is moving ahead to fund10 beds at two new facilities immediately and is considering a commitment to an even more ambitious new program commencing July 1.

--The Roman Catholic Archdiocese, which will open four small hospice units, each with a capacity of 8 to 12 persons, at a cost of $1.1 million this year.

There are now only about 50 hospice beds in seven private institutions in the county. That number is woefully inadequate to meet the needs of the current caseload of 1,600 persons having AIDS. Nor will the additional beds that are planned for later this year begin to meet the anticipated growth in the number of cases. But it is progress. And it is recognition of the importance of alterna-tives to hospitalization. Residential- and hospice-care programs have been found to be more humane and significantly less expensive than is acute hos-pital care.

Part of the problem facing the county is an almost total lack of coordination. Different agencies are moving in different directions. That lack of appropriate planning has left some areas without any facilities, including South-Central and East Los Angeles. Another problem is the lack of stand-ards. Gov. George Deukmejian vetoed licensing legislation last year. A new effort is now being made to win approval in Sacramento for minimum standards for the operations under a state licensing plan. In the meantime, the majority of services are offered without full-time professional staffing and with varying standards of care.

Los Angeles County is giving $473,450 immediately to Hospice/Los Angeles-Long Beach for five hospice-care beds and to AIDS Project Los An-geles for five residential-care beds. The county is also considering a long-term commitment to fund eight of the 24 beds being planned by the AIDS Hospice Foundation at Barlow Hospital--perhaps the most important single AIDS project under consideration. That would represent $400,000 for the fiscal year commencing July 1. The Barlow hospice would be part of a development of other AIDS projects at Barlow Hospital--including residential care, outpatient services and acute hospital care. The county’s commitment will reinforce other city, state and private efforts that are being made to develop Barlow as a center of AIDS services, ensuring that renovation can commence immediately.

The absence of planning may be addressed when a five-year plan is completed next month by a consulting firm hired by the county. The absence of coordination, including coordination among public and private agencies, could well be remedied by the County AIDS Commission established by the Board of Supervisors, which already has demonstrated skill in unsnarling complex issues related to the disease.