AIDS Problem Demands Federal Help : County should apply for Medicaid ‘demonstration’ funds to bolster early detection efforts

Every cut that is designed to balance the Los Angeles County budget has its repercussions. One of the most serious impacts may be felt by those who suffer from AIDS. Acquired immune deficiency syndrome has been diagnosed in more than 6,000 San Fernando Valley residents in the last three years. That gives the Valley the county’s highest number of full-blown AIDS cases.

On the face of it, one could easily assume that the county health system is well-prepared to meet the need. After all, congressional action means that the $633 million in AIDS funding from the Ryan White CARE Act is finally nearing reality. And the Los Angeles County Board of Supervisors has voted for a sufficient amount of local AIDS funding to satisfy matching fund requirements for more than $31 million in Ryan White money. Unfortunately, it’s not that simple.

The county budget crisis is a complicating factor. The county’s plan to close nearly all of its 45 neighborhood clinics and regional health centers severely impacts most of the critical early detection work for HIV, the virus that causes AIDS, according to Dr. Andrea Kovacs, director of the county’s AIDS programs for women and infants at County-USC Medical Center. Most of this detection work occurs in those clinics, particularly in the clinics that offer prenatal care.

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

Said Debra Cummings of the Valley HIV Consortium, “It’s going to be a public disaster.” The consortium is a group of 25 agencies that provides HIV-related services to residents of the San Fernando, Santa Clarita and Antelope valleys.

The same fears about the impacts of local health budget cuts were echoed by Patricia S. Fleming, national AIDS policy director for the Clinton Administration.

This situation is just one of the reasons why we so strongly urged county officials to quickly apply for a federal Medicaid “demonstration” project. If approved, it would immediately provide about $178 million. It would also allow the county to shift from its costly, outdated and inordinately expensive inpatient hospital system to a far less expensive outpatient model, where preventive health and early detection are the focus. That would be one effective way to offset the repercussions of dire cuts in our public health system.