SACRAMENTO — Gov. Arnold Schwarzenegger's administration flouted a six-year-old state law by failing to enact a program intended to provide medical care to impoverished Californians with HIV, a Los Angeles County Superior Court judge ruled in a decision made public Thursday.
Writing that the state "has not fulfilled its statutory obligation," Judge James C. Chalfant ordered the state Department of Health Care Services to carry out the program, which is supposed to help people with HIV -- but not AIDS -- obtain treatment through the state's Medi-Cal program for the poor. Medi-Cal already covers people once their illness fully develops, when the cost of care is often much higher.
Hundreds or possibly thousands of people with HIV have lost out on healthcare because the state resisted enacting the law, said Michael Weinstein, president of the AIDS Healthcare Foundation, the Los-Angeles-based nonprofit that brought the lawsuit.
Weinstein said the healthcare department "never had any intention of enforcing this law because they thought they had a right to determine which laws they enforce or don't."
Department officials said they hadn't fully reviewed the ruling or decided their next step but reasserted that they had acted appropriately and that the law would not work.
More than 1 million Americans are HIV-positive and about 56,300 annually contract the infection, according to the federal Centers for Disease Control and Prevention. About 15,000 Americans die of AIDS each year. Some of the largest concentrations of people with HIV and AIDS are in the Los Angeles and San Francisco areas.
The 2002 law, signed by then-Gov. Gray Davis, ordered the department to encourage AIDS patients to voluntarily switch from expensive fee-for-service treatments to more cost-effective managed care, with the goal of using the savings to help cover people with HIV. At the time it was hailed as a major step in combating AIDS.
But the judge ruled that the healthcare department failed to take some of the steps required by the Legislature and made lackluster stabs at completing others.
The ruling faulted the department for a minimal effort in reaching out to AIDS patients to encourage them to move to managed care. Chalfant wrote that without evidence, the department assumed that federal medical privacy laws would prohibit it from contacting people.
