Cuts Pose Threat to AIDS Programs, County Workers Say

AIDS programs, particularly those for infected women and infants, will be seriously undermined by budget cuts despite the County Board of Supervisors’ vote to fully fund local AIDS services, county health workers warned Friday.

The problem is that although the supervisors have budgeted $57 million for AIDS programs--enough to satisfy federal matching requirements--they are closing neighborhood clinics and health centers where the AIDS virus often is first detected, the health workers said.

Dr. Andrea Kovacs, director of the county’s HIV and AIDS program for women and infants at County-USC Medical Center, said most of the important early detection work is done at clinics, particularly those with prenatal programs.

“Now these women won’t be identified because they won’t get HIV testing and counseling,” she said. “They won’t identify the babies. We will have an infected child who otherwise might not have been infected. The cost of that down the line will be tremendous.”

Kovacs also said the clinics won’t be there to provide infected mothers and babies with follow-up treatment, a key component in the fight to control the AIDS virus.

The word of the AIDS threat came after a tour of County-USC by Patricia Fleming, President Clinton’s chief policy adviser on AIDS.

She brought county officials good news, saying the Board of Supervisors’ vote on AIDS funding appeared to be enough to satisfy matching requirements of the Ryan White CARE Act. That means the county will receive its $31-million allotment of money from the act, which will be spread throughout the county to provide financial support for AIDS treatment and HIV testing programs.

While Fleming has been here, she has visited Los Angeles Mayor Richard Riordan, met and toured private AIDS programs, such as AIDS Project Los Angeles, and grilled physicians and researchers at the sprawling County-USC east of Downtown about the budget cuts. She will wrap up the four-day visit today and return to Washington.

Part of her mission was to rally support for Clinton in his fight to defeat Republican-proposed cuts in the federal Medicaid program, known as Medi-Cal in California. The cuts would reduce spending by $182 billion over seven years and have a “devastating impact” on the Medi-Cal program, Clinton’s adviser said.

Fleming, who attended a news conference at the medical center and later met with reporters and editorial writers at The Times, said that with the cuts the state would lose a total of $18 billion in Medicaid payments from 1996 to 2002, and could be forced to knock 1.2 million of the 5 million recipients out of the program.

Fleming said Medicaid pays for far more AIDS treatment than the Ryan White Act.

“Medicaid pays for six times the Ryan White budget,” she said. This year Medicaid spending on AIDS services will be $3.6 billion, compared to $633 million for the Ryan White program nationally, she said.

Locally, the Board of Supervisors, in an effort to close a $655-million budget gap in health services funding, voted earlier this month to close nearly all of its 45 neighborhood clinics and regional health centers.

At the same time, the supervisors voted to maintain their current level of funding for AIDS programs, including full funding for the nationally known 5P21 Rand Schrader Clinic, a part of County-USC that annually treats 4,000 AIDS and HIV patients, more that one-third of all such patients in the county.

Dr. Alexandra Levine, chief of hematology at County-USC and a specialist in AIDS treatment and research, said that even though AIDS programs are relatively well funded compared to other health programs, serious problems will develop because many of the doctors and nurses who treat AIDS patients could be let go as a result of budget cuts elsewhere.

“If you don’t have the ophthalmologists, the radiologists, the oncologists and other specialists, then we can’t really function the way we are accustomed to functioning,” she said.

HIV infection is the leading cause of death for men 25 to 44 in Los Angeles and 11 other California cities with populations of more than 100,000. According to federal statistics, 33.7% of all deaths in Los Angeles in 1992 were caused by HIV.