The Tasks That Await the Liberals

The day before liberals assumed majority control of the Los Angeles County Board of Supervisors, I visited County-USC Medical Center to check out the work that awaited them.

That was Monday. Tuesday was Supervisor Gloria Molina’s first meeting, making it the first time since 1980 that the board would not be under conservative control. Liberal Democrat Molina replaced conservative Republican Pete Schabarum. Adding her vote to those of liberal Democratic incumbents Ed Edelman and Kenny Hahn promises major changes in county policy.

And now, after all the campaign promises, it’s time to produce.

At the top of the list is the county public health system, which affects all our lives. From the poor, uninsured busboy with stomach trouble who can’t take time for a six-hour wait at a county clinic, to the more prosperous restaurant patron infected by the sick worker’s ailment--we all have a stake in the county Department of Health Services.

But the department, which operates county hospitals, health clinics, inoculation programs and other public health services, is in bad shape. A decade of federal and state cuts in social service appropriations, plus the Proposition 13 reduction in county tax revenues, have hurt this particular patient. So have conservative votes which gave law enforcement a higher priority than health care.

During the campaign, Molina and her opponents recognized the gravity of the problem. But their promises, mainly involving finding more money from vague sources, were difficult to pin down.

While more money is clearly needed, it isn’t the whole answer. When I visited the hospital, I found that things were considerably more complicated than writing checks from the thin government bank account.

I spent most of my time at the sprawling facility talking to AIDS experts. AIDS provides a good example, because it is such a powerful, complex illness that it requires many medical techniques to deal with ravaged bodies and psyches. And there are growing numbers of patients in Los Angeles County. There have been 11,336 AIDS cases in the county since 1981 and, of these, 7,787 have died. The number of people infected with the human immunodeficiency virus (HIV) is around 110,000, although many have not yet developed AIDS.

Once the disease has surfaced, and the sick person can’t afford private care, it takes five or six months for a patient to be admitted to the AIDS outpatient clinic at County-USC Medical Center, a wait that can be fatal.

Inside the clinic, there are more waits in long, poorly lighted hallways, lined with benches and couches. On Monday, four AIDS patients sat in a hallway, receiving blood transfusions that take about six hours. Color sets attached to the walls showed the morning TV fare. A man rested on one of the couches, half-dozing, waiting for a doctor to see him. In a dingy side room, two men watched TV while receiving inhalator therapy. About 2,500 patient visits a month are made to this shabby facility.

Help is coming. Almost $4 million in additional funds are on the way from the federal AIDS bill named for Ryan White, the teen-ager whose fight against and death from the disease attracted national attention. A new outpatient clinic will open in May, capable of handling 1,000 more patient visits a month. That will substantially reduce the waiting period, county officials say.

What’s left to do?

Part of it is management. The board will have to decide how to divide funds between big county facilities and small, neighborhood clinics that don’t have the equipment of large hospitals but offer more personal care. That’s a hot issue, for the community groups mobilize substantial political support.

Part of it is politics. That’s the decision on whether the county should distribute condoms, clean needles and bleach in AIDS prevention programs. The amount of money involved in such distribution is comparatively small, but it has great symbolic value to the gay community. “It sends out a message that we will do what is necessary to stop the spread of AIDS,” said Michael Weinstein, president of the AIDS Health Care Foundation. Today, the Los Angeles County Commission on AIDS is expected to ask the supervisors to support such a program. “It will be valuable to distribute bleach kits to drug users,” said Municipal Judge Rand Schrader, commission chairman.

Schabarum opposed that, as did conservatives Mike Antonovich and Deane Dana. An Antonovich aide said the supervisor still opposes the idea. Liberal Hahn doesn’t much like the idea either. That means the proposal is still a long shot.

Politics and management. A tricky combination for the new board majority to handle.