A $5-million, state-guaranteed revenue bond issue to finance construction of four Los Angeles AIDS hospices--where terminally ill patients can go to die with dignity--was preliminarily approved Thursday by the California Health Facilities Financing Authority.
"It's very difficult to cross the bridge of no hope," said Michael Weinstein, president of the Los Angeles AIDS Hospice Foundation, a nonprofit group that applied for the bond issue, which he said would be the first such bond issue in the United States.
Weinstein said plans call for an additional 25-bed AIDS hospice unit to be built on the grounds of the old Barlow Hospital in Elysian Park, where another previously approved 25-bed unit is scheduled to open late next month.
Negotiations are also under way for a third 25-bed unit at Norwalk Metropolitan State Hospital, plus a 25-bed unit at an unselected South-Central Los Angeles site and a fifth 25-bed unit to be located somewhere else in the county, according to the foundation president.
Headed by Elizabeth M. Whitney, acting state treasurer, the authority is scheduled to consider granting final approval to the $5-million project at its December or January meeting. There was no opposition at the preliminary approval hearing.
Last month, the authority approved a $300,000 state-backed loan to help establish the first 25-bed unit at Barlow. County and city funds and private donations also are being used for this facility.
The authority is authorized to issue revenue bonds for hospital expansion purposes, which are repaid by hospital income. No state tax dollars are involved unless the hospital cannot repay a loan.
"The cost of hospice care for terminally ill AIDS patients is one-fourth of what it costs in acute care facilities," Weinstein said. "It also means more humane and compassionate care for people with AIDS and their families, in a home-like setting."
Statistics show that there will be 44,000 cases of AIDS in Los Angeles County by 1991, according to the foundation president, with an estimated 10% of those patients in need of hospice care at any given time.
The use of hospices to care for the terminally ill was first aimed primarily at cancer patients and the elderly. Trained nurses and other support staff provided a comfortable environment and maintenance care to patients in their final weeks of life.
As AIDS spread through major American cities during the mid-1980s, a growing number of doctors, health care experts and advocates for AIDS patients suggested that many victims of the disease could be better served in hospices than in hospitals. Terminally ill patients often complained of being shunned by overworked hospital workers and felt uncomfortable in hectic hospital wards.
But until recently, many states have had difficulty opening hospices because of a thicket of licensing regulations and questions about how hospice care would be funded.
The Los Angeles Catholic Archdiocese, for example, studied those issues for two years before deciding to open a group of hospice-like shelters. Until last year, several underground hospices--which existed independently of any regulation--provided the only such care in Los Angeles.
Even when funding and support has been available, hospices have been opposed by neighbors fearful of the presence of dying AIDS patients. In the Hollywood-Wilshire district, neighbors fought a hospice that opened last year in their residential neighborhood. The Los Angeles Zoning Board ultimately ruled in August that the hospice could continue to operate.
In the last year, several hospices have finally opened in Los Angeles, including the Barlow hospital site, which is being financially aided by the county.
On Thursday, plans for a West Hollywood AIDS hospice dedicated to the late ventriloquist Wayland Flowers were announced by his manager and Hospice/Los Angeles-Long Beach.
Flowers, 48, whose television and nightclub success was shared with a cackling, risque puppet named "Madame," died Oct. 10 of what a family spokeswoman said was cancer.
On Thursday, however, his friend and manager, Marlena Shell, said he died of AIDS and announced the formation of the Wayland Flowers Foundation to raise money for the new hospice.
According to Hospice/Los Angeles-Long Beach publicist Nancy Cooper, "He spent his final days in Hughes House in Hollywood," a hospice operated by the organization.