City Council Sets Major Goals in Policy on AIDS : Health: Lawmakers support a measure that includes giving condoms to prisoners and bleach to drug users. But cooperation from county and state is needed to implement the plan.

The Los Angeles City Council on Tuesday approved a sweeping AIDS policy that requires comprehensive AIDS education for all city workers and endorses a number of nationally controversial measures, including the distribution of condoms to prisoners during incarceration and bleach to drug users for sterilizing needles.

The policy, largely the work of the city’s retired AIDS coordinator, Dave Johnson, passed by an 11-1 vote. Proponents on the council called it a landmark policy, bringing together in a single document the myriad regulations and principles spawned by the AIDS epidemic.

Even its backers acknowledged that implementation of much of the policy will require widespread cooperation of county and state officials--by no means assured--as well as increases in funding.

Calling the AIDS crisis a “natural disaster and a global emergency,” the document emphasized the rights of those infected with the AIDS virus and the need to avoid public hysteria in efforts to contain the virus’ spread. It also contains nitty-gritty sections on how to clean up spills of potentially infected blood or body fluids and exactly who can say what to whom in the process of protecting the confidentiality of infected persons.

Councilman Joel Wachs, the policy’s principal sponsor, said he expects it to serve as a model for municipal, county and state governments nationwide.

Whether the AIDS policy becomes a blueprint for other governing bodies is more than an issue of pride. Many of the policy’s goals cannot be implemented unless county and state governments adopt them, too.

The jails are controlled by the Los Angeles County Board of Supervisors. Twice, the supervisors have gone on record against public distribution of condoms and bleach to addicts and others at risk of HIV infection, rejecting the advice of their advisory commission on AIDS. The issue of giving condoms to prisoners has not come up, but aides to the most outspoken opponents of condoms and bleach, Pete Schabarum and Mike Antonovich, said the city’s policy declarations are unlikely to change their minds.

Another area where county support is critical to implementation of the city’s goals is in the treatment of HIV infection. The policy calls for timely access to care for all HIV-infected people, regardless of their ability to pay. But the county hospital and health-care system is so overcrowded that patients seeking an appointment in the outpatient AIDS clinic at County-USC Medical Center must wait 21 weeks, according to county health officials.

“The issue is, ‘Where is the money for it?’ ” said Rand Schrader, a Los Angeles Municipal Court judge who is chairman of the Los Angeles County Commission on AIDS. “The federal government has not provided money that the county or the state can use to do that. It ought to be done--morally, it should be done--but at this point the money just isn’t there.”

The city’s chief monetary obligation under the policy is to hire health educators to implement AIDS education programs for the city’s 33,000 employees, according to Phill Wilson, the incoming city AIDS coordinator. In addition, the $1 million allocated by the city to provide housing for homeless AIDS patients will probably grow as the epidemic grows. About half of the 112,000 county residents believed infected with HIV live in Los Angeles, city officials estimate.

Wachs acknowledged that much of what the document advocates requires action outside the city’s jurisdiction. He contended that the city still must play a leadership role.

“It is a step in the city trying to come to grips with the problem even though it by no means solves the problem,” he said.

David I. Schulman of the city attorney’s office, who helped draft the policy, said one of its chief attributes is the melding of educational programs about the transmission of AIDS and training in the legal protections for people who are infected.

The policy also stipulates that the city use existing community-based AIDS programs to confront the epidemic rather than set up its own programs. Schulman described that as a key philosophical underpinning of the policy, recognizing that community groups are just as important in the fight against AIDS as governmental action.

Councilman Ernani Bernardi was the only one to vote against the policy, calling its guarantees of confidentiality for those with HIV a “cop-out” that strips health officials of their main weapon in combatting an epidemic: knowing who is infected.

Also opposed were about 10 demonstrators from a group called the Coalition for Common Sense, who picketed in front of City Hall and later spoke against the policy at the council meeting.

Fabian Asensio, spokesman for the group, said city workers ought to be able to know which of their co-workers are infected so they can protect themselves.

The AIDS policy also contains a legislative agenda, putting the city on record on a number of issues surrounding AIDS. As part of the agenda, the city endorses the distribution of bleach and condoms. It also declares opposition to U.S. immigration policies that restrict entry of HIV-infected people, opposes mandatory testing beyond what the law now permits, favors expansion of AIDS education in elementary, secondary and college curriculums, and calls for more services for women and minorities who have been under-served by AIDS programs.

City departments have six months to figure out how to implement the policy. The city personnel department must come up with an estimate on what implementation will cost for all departments, while the community development department has been charged with estimating the policy’s long-term fiscal implications.