National AIDS Commission Ignoring San Diego, Officials Say

The National Commission on AIDS is ignoring San Diego’s “unique circumstances” during a three-day fact-finding session in Los Angeles that was designed to measure the extent of the public health crisis in Southern California, a San Diego County health officer said Thursday.

The commission, an advisory panel that is crafting the country’s AIDS policy, will spend today at Los Angeles-area facilities, where they will seek first-hand information about the treatment barriers faced by people with AIDS.

The head of the AIDS commission said Thursday the panel will seek emergency disaster relief money for the cities hardest hit by the AIDS epidemic because of inadequate federal, state and local funding.

Commission members said they would seek congressional support for a bill that would provide emergency funding--similar to relief provided for communities crippled by earthquakes, floods and hurricanes--for Los Angeles, New York, San Francisco, Newark and Miami.

“Because AIDS is a disaster--a human disaster,” said Dr. June E. Osborn, chairwoman of the commission, “it’s quite clear the areas that have been hardest hit are in need of more funding.”

San Diego was not on the list for funding. Binnie Callender, chief of San Diego County’s Office of AIDS Coordination, who learned of the AIDS program early last week, said Thursday that San Diego’s AIDS-related interests “were not being recognized” during the three-day program. An estimated 60 AIDS experts from Southern California were scheduled to speak at the meeting.

Early last week, a commission staff member told Callender that “the agenda was filled,” and that San Diego would not be represented. Commissioners subsequently granted the county’s Office on AIDS Coordination five minutes to explain San Diego’s unique circumstances.

AIDS office spokesman Dale Fleishman on Thursday delivered an overview to the commission that “explained the unique characteristics of San Diego, which has a need for (AIDS-related) services and funding,” Callender said. “We wanted (the commission) to be aware that San Diego . . . has a need.”

Callender demanded Thursday that commissioners return to Southern California and spend a full day in San Diego.

The hearing was its first outside the nation’s capital since the panel was formed last year. Eunice Diaz, a professor at the USC School of Medicine and a member of the panel, said she lobbied for the local hearing “because L.A.’s position with regard to the AIDS crisis needs to be acknowledged on a national basis.”

Several commission members said they were stunned by the lack of AIDS treatment facilities and health care funding in Los Angeles. Commission member Scott Allen said he was “surprised at the lack of compassion here,” evidenced by the fact that the county Health Department provides only one 22-bed AIDS inpatient clinic in an area with the nation’s second-highest total of reported AIDS cases.

But San Diego has its own problems providing care for AIDS patients, Fleishman said. He told commissioners that the Los Angeles meeting failed to recognize that San Diego is “geographically, economically, politically, culturally and socially an entirely distinct community from Los Angeles.”

“(As such) there are several influences on the HIV epidemic that distinguish San Diego from the rest of the country,” Fleishman said.

Unlike Los Angeles, San Diego’s AIDS population includes a “significant” number of HIV-infected Navy personnel who, upon discharge, remain in San Diego where they seek treatment, Fleishman said. San Diego’s AIDS crisis is also uniquely linked to the county’s proximity to Tijuana, where “HIV education and services are severely limited,” Fleishman said.

San Diego’s incidence of AIDS among intravenous drug users has lagged the national rate, but “there are numerous indications that there is a large vulnerable population of drug abusers” in the county, Fleishman said.

San Diego accounted for 1.4% of the nation’s--and 6.8% of California’s--reported AIDS cases through October, 1989. The county’s incidence rate for the past year was 20 per 100,000 population, with the incidence rate shooting up to 140 per 100,000 in Central San Diego. Those rates are “44% and 1,000% higher than the current national incidence rate,” Fleishman said Thursday.

State health officials have predicted a decline in the incidence of AIDS in San Francisco and Los Angeles during 1990, but “there are no such projections for San Diego or other areas of Southern California,” Fleishman said.

Fleishman told the AIDS commission that treatment programs available for people with AIDS in San Diego are severely limited by a money shortage.

“San Diego ranks 57th out of 58 California counties in per capita revenue reallocation from the state, leaving few dollars available for non-mandated programs,” Fleishman said.

That fund shortage leaves San Diego with “grossly inadequate resources” to treat AIDS patients, Fleishman said.

Although other counties provide AIDS treatment at public hospitals, San Diego’s lack of a county medical facility leaves “the UC San Diego Medical Center as the primary care facility, with other treatment services scattered among community clinics, private physicians and the private hospitals,” Fleishman said.

The picture is gloomier for inner-city residents in need of AIDS-related medical treatment because “the major private hospital serving the black community is facing financial hardships and must function at a minimum service level in order to keep its doors open,” Fleishman said.

Fleishman urged the AIDS commission to “plan a strategy” that will meet the needs of Los Angeles and “the next tier of urban and suburban areas such as San Diego.”

“The state projects that, by 1992, there will be more people living with AIDS . . . (in) San Diego, Orange, Riverside and San Bernardino counties than in either San Francisco or Los Angeles,” Fleishman said.

Times staff writer Kenneth J. Garcia contributed to this report.