California Leads States in Spending for AIDS Programs

States spent $252 million of their own money on AIDS programs in fiscal 1989, a sharp increase over the previous year, with California heading the list at $77 million, a study released Wednesday reported.

“As the epidemic spreads, more and more states are feeling its fiscal impact and are realizing that there’s only so long they can rely on federal dollars to cope,” said Mona J. Rowe, one of the authors of the study.

The report, compiled by George Washington University, found that states spent nearly $500 million in combined state, federal and private funds, excluding Medicaid, on AIDS activities in fiscal 1989. The largest amounts were devoted to education, patient care and testing and counseling.

The $252 million spent by the states represents an increase of $100 million, 62% more than the previous fiscal year.

“As state and local governments assume increasing fiscal responsibility for solving social problems, AIDS will become another of the pressing issues forcing difficult political and budgetary trade-offs,” the study said.

“It is not surprising that the majority of states continue to rely heavily on federal funds to support the bulk of their AIDS activities,” it continued. “Yet few states rely solely on federal dollars, and few of those with a high prevalence of the disease have been able to avoid allocating millions of their own general revenue to the problem.”

The study said that between fiscal 1986 and fiscal 1989, spending by states alone increased ninefold, in response to the rate of growth in AIDS cases over the same period.

Although only a few states allocated money for AIDS research, reflecting “the historical role of the federal government” in that area, California was a startling exception, with nearly $18 million earmarked for research.

“California is the only state that has passed several bills supporting the development of biological research,” Rowe said. “California has a large university-based system that has developed an expertise in AIDS. The state clearly wants to continue to maintain the initiative in that realm.”

California, which ranks second nationally in the number of AIDS cases, also outspent every other state in education and in testing and counseling, allocating about $19 million in each of the two areas. New York, which leads the nation in AIDS cases, was second, spending a little more than $10.5 million in both areas.

“California, in terms of absolute dollars, has definitely made a commitment in education and information, testing and counseling and research,” Rowe said.

Responding to the study, Gov. George Deukmejian said the latest research shows that “California’s commitment to fighting AIDS is unmatched.”

The study said that education and testing and counseling were the two program areas most likely to attract state funds. The study said that 41 states dedicated general revenues to supplement federal funds for AIDS education and information, while 35 spent general revenues to support testing and counseling activities.

California and four other states--New York, Massachusetts, Connecticut and Rhode Island--are spending $2 to $3 per capita for AIDS programs. The District of Columbia, which has a relatively high percentage of cases, is spending $9.91 per capita, more than any state. Hawaii is second with $3.62 per capita.

Compared to last year, almost all states reported an increase in state funding for AIDS programs, although the rate of increase varied. The state of Washington, for example, reported a twelvefold increase from fiscal 1988, while Georgia reported a tenfold rise, the report said.

But states such as California and New York, which previously had budgeted significant amounts for AIDS activities, experienced smaller percentage increases, the study said. California and New York reported increases of 31% and 35%, respectively.

State appropriations for patient care experienced large increases in the last several years, the report said. Florida, for example, third in the nation in the prevalance of AIDS, budgets about 70% of its state funding to inpatient care services, including hospice care.

Ten states reported using state funds for programs involving the antiviral drug AZT, the study said.