The Los Angeles County Commission on AIDS, citing the need for more medical care for the growing numbers of AIDS sufferers, approved guidelines Friday urging county hospitals to make more room for patients and asking private hospitals to designate AIDS wards.
The recommendations were two of several that the commission made that are aimed at providing greater inpatient and outpatient care for victims of acquired immune deficiency syndrome. The suggested measures require approval of the Board of Supervisors.
Included are proposals to establish social service and mental health programs for AIDS victims, expand outpatient care at hospices and provide a "county ombudsperson" to coordinate AIDS-related services for patients at county hospitals and clinics.
"We have given what we consider to be a comprehensive guide to what is needed to (deal with AIDS) in the county," said Dr. Wilbert Jordan, who chaired the commission's Access to Medical Care Task Force.
"This is reality," he added. "We have a problem, and this is the best way of approaching it to, 1, deal with treating those patients and, 2, cut down the rate of infection of people who are not infected."
Jordan, a physician and director of the AIDS clinic at Martin Luther King Jr./Drew Medical Center, said he hopes to enlist the support of conservative supervisors who have resisted some of the commission's previous efforts to curb AIDS, including programs aimed at intravenous drug users and homosexuals, who are at high risk.
"This is the first time that we have a plan that takes into account each group's uniqueness and doesn't just focus on one group. This gives parity to all groups affected by AIDS, including blacks, Hispanics, the gay community, children and expectant mothers," Jordan said.
Robert Gates, the county's health services director, said he supports the recommendations in general but wants to review them more closely and report to the commission next month.
No Cost Estimates
The commission did not attach detailed cost estimates to its latest proposals, nor did it say where the funds would come from other than to say the county should sponsor legislation to increase state and federal aid to fight AIDS.
The panel suggested that the county explore cooperative agreements with private hospitals to help them set up AIDS-dedicated wards and that ways be found to reimburse the hospitals for the added costs.
The commissioners called for an increase in the number of AIDS victims treated at county-run outpatient facilities to 3,000 visits a month for those with AIDS or AIDS-related complex or to 10,000 visits a month from people infected with the human immunodeficiency virus who have yet to develop AIDS symptoms.
About 1,600 AIDS or ARC patients are being seen monthly at county hospitals, with most of those at County-USC Medical Center, but only a small number of the asymptomatic HIV-positive patients are being treated at county facilities, health officials said.
Richard Cordova, administrator at County-USC Medical Center, told commissioners that there are plans to expand outpatient care for up to 5,000 patients a month at his facility, more than triple the current load. But the commission, in its report, also stressed the need to boost the capacity of inpatient care at County-USC.
For example, some community activists warned that a 20-bed AIDS ward scheduled to open in the fall at County-USC is too small for even the 50 to 60 AIDS patients already housed there.
"It doesn't make sense to me to be talking about an inpatient care facility that's a year away that provides only one-third the need," said Phill Wilson, chair of the Black and Gay Leadership Forum.
The proposals came a day after the county Department of Health Services released its monthly statistics, which showed 6,135 confirmed AIDS cases in the county as of Dec. 31, 1988, including 48 children. Eighty-three cases are awaiting investigation.
The report also noted that the percentage of AIDS cases involving Latinos rose from 16% to 17%.