Mirroring a pattern that has emerged in recent surveys of the nation's top 500 companies, few San Diego companies have established policies that outline the rights and responsibilities of employees who contract AIDS.
Additionally, few companies have created programs to help supervisory personnel cope with on-the-job tension that can surface when co-workers learn that a fellow employee--or a supervisor--is diagnosed as having AIDS.
"There are only two possible responses--pro-active, before something happens, and reactive, after someone has AIDS," observed Jane Adolph, health services coordinator at the San Diego-based Kelco Division of Merck & Co. Inc.
Companies that address the highly emotional issue before an AIDS case occurs usually "can reduce anxiety among the work force," according to Erika Shatz, health education coordinator for the San Diego AIDS Project. "But that calls for foresight, and (education) usually is undertaken because someone already has AIDS."
Awareness will spread as corporations begin to absorb the astounding medical costs generated by AIDS care, Shatz said. Corporations can reduce AIDS-related care costs by revamping their catastrophic care plans to include home attendant care, Shatz added.
"The Centers for Disease Control estimates that the average case costs $149,000 from diagnosis to death for hospitalization, while (a San Francisco study) has found that use of volunteers and home attendant care can reduce the cost to $29,000," Shatz said. "That's a pretty good incentive."
Some companies, including Home Federal Savings & Loan, have adjusted their catastrophic-illness coverage to include at-home care. The S&L also has been educating employees about the coverage, according to Jane Alfano, Home Federal's employee benefits manager.
In addition to adjusting insurance coverage, Shatz said corporations must start to concentrate on programs that boost AIDS awareness. Only a handful of San Diego-based employers, including Kelco, San Diego Gas & Electric, Home Federal Savings & Loan and San Diego State University, have created policy statements or education programs, according to the San Diego AIDS Project.
However, human relations and health professionals anticipate that more programs will be created as the number of AIDS cases in San Diego County increases.
"We do hope that as the burden increases within corporations, as they cope with employees who are getting sick or anxious, that more corporations will do something," Shatz said.
Companies that develop AIDS information programs are exhibiting "a terrific commitment to their employees," Shatz said. "Employees really feel better that their company has looked into the issue. It shows a strong commitment to labor."
A recent national survey suggested that fewer than 20% of the nation's Fortune 500 companies have policies designed to help employees with AIDS--despite the fact that 33% of the nation's largest companies have reported AIDS cases.
"Sometimes the corporation thinks there's no one affected among their ranks when there actually has been a case," Shatz said. "And even though (AIDS) has been reported in a third of the companies, still well over 75% say they have (no programs) in place and are not considering putting something in place."
SDG&E realized it needed to address the AIDS issue in 1983, after a handful of employees who were concerned about catching AIDS refused to practice mouth-to-mouth resuscitation on dummies used in a cardiopulmonary resuscitation program.
"We figured that the best defense is education," according to Jerry Brull, manager of SDG&E's safety department.
A brochure circulated last year to all SDG&E employees provides answers to basic questions about the fatal disease. The utility also posted a one-page policy statement.
Home Federal began work on an AIDS policy several months ago, after a Los Angeles-based employee who initially was thought to be suffering from AIDS was diagnosed as having AIDS-related complex (ARC). In that case, the afflicted employee "came forward to raise the comfort levels of co-workers," Alfano said.
Home Federal has created informational programs that describe the company's benefits and dispel myths about the disease. The S&L has asked AIDS project offices around the state to help conduct the programs, Alfano said.
The S&L, with 4,300 employees, has since reported two cases of AIDS. In one instance the employee has gone on an extended leave, while the second employee is still at work. "Everyone in the entire office is aware of (the disease)," Alfano said. "We had someone from the local AIDS project office come in and talk to employees and the managers."
Managers appreciate expert advice that will help them manage when an employee contracts AIDS, Alfano said, if only because discrimination against AIDS victims is illegal.