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AIDS: One More Chance

January 06, 1988

A new effort to win approval of the state's omnibus AIDS legislation, the first in the nation to implement the recommendations of Surgeon General C. Everett Koop, will be made Thursday in Sacramento. It is an opportunity not to be missed.

Assemblyman Art Agnos (D-San Francisco), who will become mayor of San Francisco on Friday, has sent a new version of AB 87 with amendments intended to respond to complaints of both doctors and Republicans. So far the doctors have responded by withdrawing their opposition but refusing their support, and the Republicans, in what we think is a grave error, have refused all support with the exception of a single member of the Assembly who is himself a physician.

The critical element of this legislation is the creation of a state commission to coordinate, for the first time, the state's programs responding to the pandemic of the acquired immune deficiency syndrome. The value of coordinating commissions at all levels of government has already been demonstrated.

Gov. George Deukmejian will play a decisive role on the omnibus AIDS legislation. His support would end the risk that AIDS might be converted into a partisan issue, as seems the intent of some Republican leaders in the Legislature. And it would bring his Administration into line with the initiatives taken by the Republican Administration in Washington, including President Reagan's creation of a national AIDS commission and Dr. Koop's support of this state approach.

The legislation is supported by more than 50 statewide organizations--including the professional organizations of dentists, nurses, hospitals and health officers, as well as the state Conference of Catholic Bishops. The California Medical Assn. has refused support because it wants further concessions in the confidentiality rules. That seems shortsighted. Under amendments made at the medical association's request, the legislation would allow doctors to share AIDS virus test results, with the oral consent of the patient, with all concerned health-care providers on a confidential basis. That is a significant relaxation of present limits on sharing test data. Further amendments may be necessary. But the most effective way to find out whether they are required will be to create the state commission, which would be in an ideal situation to explore this issue along with other priority problems.

Some Republicans are withholding support because of the bill's provision on discrimination. There is a paradox in that, for the bill's original anti-discrimination provisions were removed by Agnos and replaced simply by an endorsement of the findings of the State Fair Employment and Housing Commission, all of whose members were named by Deukmejian. They unanimously found that AIDS patients should be protected from discrimination on the same basis as other physically handicapped persons.

The Assembly passed AB 87 last year with only one vote to spare. In the Senate the vote was three short of the minimum for passage. That sort of division showed that close to half the members last year understood neither the importance of responding to the surgeon general's strategy nor the urgency of prompt action. The statistics alone signal the need. Last year California had 4,386 new cases, an increase of 44% over the previous year, and 2,772 deaths. The state has had 11,181 cases and 6,088 related deaths since reporting began in 1981, representing 22% of the nation's cases and deaths. The problem is growing. And with it, demands for services--demands that require the coordinated response that a state commission can best provide.

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