Stepped-Up AIDS Care

The Los Angeles County Board of Supervisors has set an example for other counties with a $2-million plan to finance long-term care, including hospice care, for AIDS patients.

Under the plan, to begin July 1, almost 15,000 patient days of care will be funded through programs in each of the five supervisorial districts of the county. This will be in addition to continuation of the county program for home care, which is provided through the Los Angeles and Long Beach Visiting Nurse Assns., and an extension of home-care support that will be possible under Medi-Cal commencing July 1.

A substantial number, perhaps a majority, of those benefiting from the $2-million long-term-care program will be those suffering from dementia, a growing portion of the AIDS population. Because of failing mental faculties, they are unable to maintain themselves at home and often have needs exceeding those that family members or friends can provide at home.

Los Angeles County will not restrict its long-term institutional-care program to hospice cases--that is, to those with a life expectancy of less than six months. But one of the five programs to be funded will be a 25-bed hospice at Barlow Hospital in Elysian Park, where additional long-term-care and shelter facilities for AIDS patients also are under consideration. Contracts for the $2-million program will not go into effect until the next budget year, which will start July 1. However, two other long-term-care contracts for a total of $473,450 are to be signed by the county in the days ahead for funding under the current year’s budget--one with Hospice Los Angeles/Long Beach and one with AIDS Project Los Angeles.

The continued expansion of Los Angeles County’s commitment to AIDS care is welcome indeed. But there is no question that it is just a beginning. The precise needs are hard to project. There is no accurate estimate of facilities required for long-term care. Some estimates will be available next month, when a five-year plan prepared for the county by a private consultant is made public. The need for expanded facilities already is evident in the experience of San Francisco, which has an AIDS caseload that is only slightly larger than that of Los Angeles County. Despite its highly organized support program, San Francisco already is overwhelmed with dementia cases and is trying to expedite negotiations to take over portions of a 200-bed U.S. Public Health Service hospital--much of which would be dedicated to this particular AIDS population.