Valley AIDS Funds May Get Scarcer

As Los Angeles County prepares to dole out its shrinking pot of funds for AIDS services, the Board of Supervisors faces increasingly vocal complaints that the San Fernando Valley is getting shortchanged.

The county is facing a possible $4.9-million reduction in federal funding for HIV and AIDS programs this year. The result is that providers big and small are scrambling to get what they consider their fair share.

Health providers say the number of clients going to the Sherman Oaks office of the AIDS Healthcare Foundation has doubled to more than 440 over the last two years. And Olive View/UCLA Medical Center HIV outpatient clinic has seen its numbers go up 35% over the same period.

The supervisors begin their annual budget deliberations today and are scheduled to decide this week if HIV services will get fewer dollars--or if funds will be transferred from other county programs.

Providers and activists in the Valley say they are particularly worried because the area has traditionally been ignored by county officials who award AIDS funds.

“With the cuts, everyone is scrambling [for money], so if we don’t let them know we exist, we’re in trouble,” said Sharon Mitsuyasu, former co-chair of the San Fernando Valley HIV/AIDS Consortium. “We don’t want to take what we have been getting because we haven’t been getting our fair share in the past.”

The budget crunch comes at a time when other sources of funding also are drying up. For instance, the Tarzana Treatment Center will lose a $133,000 Centers for Disease Control grant at the end of the month for outreach to intravenous drug users. And the Valley Community Clinic in North Hollywood is in danger of losing its $100,000 CDC grant for educating young people about AIDS.

The accumulation of bad news has been unsettling for some.

Debbie Cummings, a nurse at the AIDS Healthcare Foundation Office in Sherman Oaks and former co-chair of the Valley HIV/AIDS Consortium, believes the loss of those grants--if combined with other significant cuts--could threaten public health.

“My concern is--if we continue to take cuts in the San Fernando Valley--that there will be an impact on public safety,” said Cummings. “I don’t want the San Fernando Valley to be on the chopping block to keep other programs secure.”

John Schunhoff, director of AIDS programs for the county, said the Valley is not significantly underfunded.

“Relative to the number of cases, it’s not that far out of balance,” he said. “No one feels they get enough, and they don’t.”

Of $46 million allocated by the county’s AIDS Program Office this fiscal year, about $5.4 million has gone to Valley-based organizations.

The Valley, providers acknowledge, does not have the county’s largest number of AIDS patients, and no one is at risk of dying due to a lack of adequate care.

But providers maintain that the Valley’s growing AIDS population is underserved in a number of ways--from lacking a representative on the county’s 48-member HIV planning body to having only 11 hospice beds for seriously ill AIDS patients.

Additionally, the Valley’s lone county hospital, Olive View in Sylmar, has only a one-day-a-week outpatient clinic reserved for HIV patients, in contrast to the four- or five-day schedules at county hospitals in the Harbor area and East and Central Los Angeles.

In the three county health districts that cover most of the San Fernando Valley area, 3,909 AIDS cases had been reported as of December. Of those, 2,722 have died, according to the county’s HIV Epidemiology Program. In Los Angeles County, the comparable figures are 32,179 and 18,051.

“I think there’s sometimes a misperception that the Valley does not have a problem [with AIDS], that there’s an affluence here so they don’t need help and people are not at risk,” said Diane Chamberlin, associate director of the Valley Community Clinic in North Hollywood.

A recent survey suggests HIV in the Valley has moved westward. According to the draft of an analysis of 18,373 people who tested positive for HIV in the San Fernando Valley from 1994 to 1996, the highest incidence of the disease appears to have shifted from the Studio City area to the West Valley. Testing positive reveals the condition that leads to full-blown AIDS.

Mark Henrickson, who conducted the analysis and is the director of the HIV Division of the Northeast Valley Health Corp., emphasized that the study is not necessarily an indicator of where the highest rates of AIDS are occurring.

The data, he said, show ZIP codes where those tested said they lived.

Results of the study cannot be extrapolated to the general population because previous studies have shown that those who seek testing are more likely to be in a high-risk group for HIV.

In parts of the West and North Valley, the positive rate for those testing was more than 10%, a disturbingly high number, Henrickson said.

If the data is correct as a wider trend, Henrickson said, it is time to change HIV policy in the Valley.

“We’re looking at the train coming toward us,” he said. “We’ve got some time now. We have an opportunity to plan for it--it’s not like an earthquake. “

Still, the Valley’s AIDS figures pale when compared with those of the Hollywood/Wilshire and other areas. But those who work with HIV patients say the Valley numbers are probably skewed downward because people there are less open about having the disease than people in some other areas, such as who the Westside.

“People over the hill are very vocal, very sophisticated,” said Terry Smith, associate administrator of the HIV division at Northeast Valley Health Corp. “In West Hollywood for instance, people are used to being out, used to being vocal. This is a less empowered community, less well-equipped to speak out for themselves. We don’t have the political base here.”

The reason for the centralization of services in the Hollywood area, activists say, is that when AIDS organizations were launched during the 1980s, they located in areas hardest hit in the first stage of the epidemic.

In the Los Angeles area--which is second to New York in the number of reported AIDS cases--those were West Hollywood and Silver Lake.

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Now that the virus has started striking larger numbers of minorities and women, a wider variety of Valley residents have been forced to go where the services are, which in many cases means outside the San Fernando Valley.

The result is a cruel Catch-22: As long as Valley residents go over the hill for HIV care, local services are unlikely to expand because the number of clients won’t warrant it.

Some providers, however, maintain that the Valley does have adequate services but people don’t know about them or that local services lack the cachet of service centers in Los Angeles proper.

“We have everything in the San Fernando Valley that is needed,” said Mauricio Perez, case manager at Bienestar, an organization that serves a primarily Latino clientele in Van Nuys and other parts of the city. “But the facilities [in the Valley] are perceived as not being glamorous. . . . What we want to do is to alleviate the stress on places in Hollywood and get better AIDS services in the San Fernando Valley.”

Mark Dwyer, an activist from Tarzana and usually a staunch defender of the Valley’s HIV services, says holes in the area’s service net make going to Los Angeles a necessity because the Valley lacks adult day care and other basics.

“If I want to go to day care, I have to go to L.A. If I want dental care, I have to go to L.A,” said Dwyer, a member of the Valley’s HIV/AIDS Consortium. “The bus takes all my energy. It’s murder on me.”

The issue that makes Dwyer and other activists most angry is that the Valley lacks a single representative on the county’s powerful Commission on HIV Health Services.

The 48-member commission recommends spending priorities for HIV dollars that come primarily from the federal and state governments. As part of the process, the commission holds a series of forums with community members around the county.

In an example local providers consider emblematic of the way they are treated, none of the 24 forums was originally scheduled for the Valley. After receiving complaints, however, the AIDS Program Office scheduled a meeting for Van Nuys on July 17.

“It hurts a lot not to have someone to scream, ‘Hold it, you’re leaving us out,’ ” said Rene Seidel, a commission member who works at the Tarzana Treatment Center. “Providers in the San Fernando Valley are not part of the political process, not familiar with the commission. It you are not part of the process, you don’t even know when to intervene.”

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