County May Not Spend All Money Available for AIDS

Despite the mounting costs of a spreading AIDS epidemic, Los Angeles County health officials estimate that more than $8.6 million available to combat the deadly disease and treat its victims may go unspent during the current fiscal year.

With the fiscal year already half over, the officials said Friday that less than $18 million of the $49.1 million allocated for AIDS-related programs has been spent. And they confirmed that in the next six months the county expects to spend about $40.5 million of the total allotment, although that number could climb higher.

“We’re moving as quickly as we can. That’s all I can say,” said John Schunoff, assistant director of the county AIDS program office who added that county spending on AIDS has increased from the $26.7 million spent last year. “We’re actually spending more this year, but it’s just not as much as our budgeted amount.”

Funds Not Lost, Officials Say

County officials hastened to add that the funds will not be lost to the county and can be applied to programs next fiscal year.

Anti-AIDS activists complained Friday that the county’s health services bureaucracy has been overly sluggish in spending AIDS-related funds, at a human cost.

“This crisis is still expanding faster than the county is responding to it,” said Michael Weinstein of the AIDS Hospice Foundation, “but a lot of the money is just going unspent.”

Referring to a weeklong vigil by AIDS patients and their supporters outside County-USC Medical Center, Weinstein accused the county of ignoring the activists.

“We’re still out there in the cold,” he said. “When are they going to take us in and let us help instead of treating us like adversaries?”

Meanwhile, Rabbi Allen Freehling, head of the county Commission on AIDS, expressed concerns that the inability of the county to spend its funds will send the wrong message to the Board of Supervisors who may be tempted to cut the AIDS budget.

“That would be a terrible risk in the face of the increasing number of people who would be infected and who would be logically expecting and demanding that the county meet its responsibilities in this epidemic,” Freehling said.

In 1987, the commission had prodded the Board of Supervisors to investigate why the Department of Health Services had failed to spend $1.5 million in home and hospice care earmarked for AIDS patients.

County officials attributed the long delay to complex county requirements that they contend had slowed the selection of outside health contractors, and Schunoff said some of those same problems contributed to delays in issuing contracts for AIDS programs.

For example, Schunoff said the county expects to spend only about $1.4 million of $2 million earmarked for residential programs. But he said unspent money could still be used the following years for residential and hospice or home care or for other AIDS-related programs.

Much of the unspent money is in the form of federal and state grants that can be carried over, he added. About $1.9 million for medical care of AIDS patients may also go unspent, he said, because county hospitals are not treating as many patients as officials originally estimated. That money would then go to assist other patients, he said. “It’s not as if that money will be wasted,” Schunoff said.

Medi-Cal Spending

The news about AIDS funding in the county came only a few days after the state Department of Health Services reported that the state Medi-Cal program spent about twice as much money per AIDS patient in Los Angeles as in San Francisco last year.

According to the report, the monthly Medi-Cal expenditures per AIDS patient were $2,953 in Los Angeles, compared to $1,514 in San Francisco. Mainly accounting for the differences were shorter hospital stays--an average 13.3 days in Los Angeles and 9.5 days in San Francisco.

The extensive system of hospices and home health care in San Francisco were cited as major reasons for the shorter hospital stays, and Weinstein said Los Angeles County should pursue such programs more aggressively.