State’s AIDS Programs Lack Direction and Commitment, Watchdog Panel Says

The Little Hoover Commission on Friday said bureaucratic obstacles and a “lack of firm leadership, commitment and sense of direction” in the state’s AIDS control effort have diluted the impact of California’s $128 million in AIDS outlays.

“While the state has committed substantial resources to dealing with AIDS, there is no coordinated effort to maximize the effect of those dollars,” the commission reported, adding that “steps toward coordination have been tentative, halting and, in general, unsuccessful.”

The Little Hoover Commission, more formally known as the Commission on California State Government Organization and Economy, is a state watchdog agency that conducts periodic studies on various issues.

The study’s key conclusion--that the state suffered from a lack of leadership and coordination--echoed that of the National Commission on AIDS last month in its interim report on the federal response to the epidemic.

As of March 31, there were 25,658 reported cases of AIDS in California, and 16,534 people had died. As many as 300,000 people are infected with the underlying human immunodeficiency virus (HIV). About 33% of the state’s AIDS patients are on Medi-Cal.

The Little Hoover Commission recommended that the governor and the Legislature designate the state Office of AIDS as the lead agency on the epidemic, making it the source of funding for all state AIDS programs. Currently the office has no control over $34 million, or more than 26%, of 1989-90 AIDS funds. That money is distributed by various state agencies, leading to “turf battles,” according to the report.

The commission also urged the Department of Health Services to take action on the widely hailed Strategic Plan issued by the state-appointed California AIDS Leadership Committee and to streamline procedures for issuing grants.

In one harrowing example of bureaucratic inefficiencies in the state grant-making procedures, the commission cited Monterey County, which spends between $200,000 and $250,000 to administer $575,000 in AIDS grants.

Robert Gore, Gov. George Deukmejian’s press secretary, said he hadn’t seen the report. He added, however, that “furnishing the funds is leadership in and of itself.” Norman Hartman, a spokesman for the California Department of Health Services, declined comment, saying he hadn’t seen the study.

“The report is right on target,” said Torie Osborn, executive director of the Gay and Lesbian Community Services Center, the second-largest community-based provider of AIDS services in Los Angeles. “But I wonder whether it will be acted upon or ignored, like so many other urgent calls to action in this crisis.”