Valley AIDS Clinic to Close in September

The largest AIDS clinic in the San Fernando Valley is closing, its officials said Thursday, in part because it’s caught in an ironic trap: New drug therapies that offer the best hope yet of beating the disease are too expensive for its budget.

The AIDS Healthcare Foundation’s clinic in Van Nuys will cease operations in September, foundation President Michael Weinstein said, a closure that will send its nearly 500 uninsured or Medi-Cal patients to seek care elsewhere.

Weinstein said the nonprofit foundation, which operates three other clinics in the Los Angeles area, had applied to Los Angeles County health officials for an additional $1 million to meet the cost of the new drugs and other expenses.

At a news conference in front of the Valley clinic, Weinstein angrily said the county had turned the request down. “It’s a cruel act in the wake of Vancouver,” he said, referring to the site of a recent acquired immune deficiency syndrome medical conference at which promising tests of the new drug therapies were unveiled.

Weinstein said when word of the funding denial came Wednesday, it was decided to close the Valley clinic because it’s the foundation’s smallest.

The decision was particularly difficult, Weinstein said, because it leaves the Valley without a full-time AIDS/HIV clinic for uninsured patients.

The closing of the clinic is very likely to fuel local activists’ contention that the Valley does not get its fair share of AIDS/HIV health-care facilities.

“Valley residents have yet another reason to be unhappy with local government,” said Cesar Portillo, director of government affairs for the foundation. “They have ignored us.”

“We had to make a cut,” Weinstein said in an interview. “And if it’s a choice of cutting the care for 500 people in one clinic or 1,000 in another, you have to go with the smallest.”

The foundation, which has a $30-million annual budget--largest in the country for a community-based AIDS care organization--was granted $5.6 million from the county this year, the same amount it received last year.

County AIDS coordinator John Schunhoff acknowledged costs had risen since then, but he said it was a struggle just to keep the funding at last year’s level.

“Every other year we were able to increase their budget, but this year we actually got a reduction in federal funds,” he said.

When asked if he thought Weinstein, in his public announcement of the clinic closing, was trying to pressure county officials to change their minds about the budget request, Schunhoff answered: “Of course.”

But, he added, there was nothing he could do--”We don’t have any more money, and that is basically all there is to it.”

The Valley clinic, which opened in January 1994, is not the first run by the foundation that has had financial troubles. Earlier this year the foundation closed its Inglewood clinic.

The recently announced advances in drug therapy involve giving patients a combination of three medicines, including one from a new class of drugs called protease inhibitors. The mixture was shown, in several studies, to greatly reduce levels of HIV, the virus that causes AIDS, to the undetectable level in some patients.

“A protease inhibitor for one month for one patient can cost $600,” Weinstein said. Scientists at the Vancouver conference said the combination drug therapy could cost as much as $16,000 a year, per patient.

Other new therapies are also costly. Implant eye surgery, which can help save the sight of AIDS patients in danger of becoming blind, costs about $4,600. A new test for viral levels costs about $1,000 a year.

Because the foundation mostly serves patients who have no private insurance and are not eligible for Medi-Cal or Medicare, it has to pay the cost of those therapies, Weinstein said.

If additional funding is not forthcoming and the clinic does close, its patients will either have to seek care at other Valley facilities--the county’s Olive View-UCLA Medical Center takes uninsured patients, as do a few other community-based clinics--or travel into Los Angeles for health care.

Several clinic patients who attended the news conference said neither option was desirable. The county hospital and clinics are crowded, they said.

“You’re a number, just cattle being rushed through,” said William Wright, 43, of Van Nuys. “This is my life they are playing with, and I don’t appreciate it.”

Casey Cannon, 39, of North Hollywood, said he credits the AHF clinic with prolonging his life. “I even moved to the Valley just to be near this clinic,” he said.

Wright said many of the foundation’s patients do not have cars and will have to take long, frequent bus rides into Hollywood for treatment. “That’s stress I don’t need in my life,” he said. Inside the clinic on Thursday, patients continued to be seen in its four examination rooms and one treatment room. Clinic administrator Zenaida Vasquez, 36, of Glendale, proudly gave a tour of the modern facility. She spoke quietly, but her voice began to crack with emotion when she talked about the fate of the clinic.

“These patients here are all my heart,” she said. “I will do anything for them. They’re a family.”