HomeMy WebLinkAboutMINUTES - 02251992 - IO.1 10
TO: BOARD OF SUPERVISORS a..... Contra
FROM: INTERNAL OPERATIONS COMMITTEE Costa
s Count
DATE: February 10, 1992 °rT;-�..uN
SUBJECT: STATUS REPORT ON AIDS PROGRAM IN THE COUNTY
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATIONS:
1 . Accept this status report on the extent of the spread of
AIDS in Contra Costa County and the projected future
directions in which the disease will spread. .
2 . Request the Health Services Director to make a further
report to our Committee on this subject during the month of
May, 1992 .
BACKGROUND:
On October 22, 1991 the Board referred to our Committee for
continuing oversight the subject of the spread of AIDS in Contra
Costa County.
On February 10, 1992 our Committee met 'with Dr. Wendel Brunner,
Director of Public Health, Francie Wise, R.N. , Director of
Communicable Diseases in the Health Services Department' s Public
Health Division and Rusty Keilch, Director of AIDS Programs for
the Health Services Department.
Dr. Brunner reviewed the attached report with our Committee and
also shared a copy of thb� attached four page "Estimates and
Projections" brochure on AIDS in this County.
We would just highlight a few of the comments made by Dr.
Brunner:
CONTINUED ON ATTACHMENT: X SIGNATURE:
RECOMMENDATION OF INISTRATOR RECOMMENDATION OF BOARD COM ITTEE
APPROVE R
SIGNATURE(S)- 5 ODER /4SUNNE WRIGHT MCPEAK
,17 ACTION OF BOARD ON a ruary , K
APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
L UNANIMOUS(ASSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ASSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. I
CC: ATTESTED
County Administrator
Health Services Director PHIL BATCHELOR,CLERK O THE BOARD OF
Wendel Brunner, M.D. , Public Health DirectUPrVISORSAND COUNTYADMInNI'ST'RA�TOR
Francie Wise, R.N. Public Health Division, HSF
� ✓��`�'�-_
M382 (10/88)
BY DEPUTY
.. x
I0-1
_2_
There have now been 700 AIDS cases reported in this County.
About 2/3 or 453 of these individuals have died. Of the total of
700 cases, the racial breakdown is as follows :
68% Caucasian
21% African American
9% Latino
The sex breakdown is :
93% Male
7% Female
A special review was made of those individuals who are currently
still alive who have AIDS since this can be expected to reflect
population groups who will be increasing their infection rates in
the future since the living individuals contracted the disease
more recently than did those who have already died.
This study indicates that AIDS is expected to increase in females
and African Americans in the future, since a larger number of
those who are living are now in these groups .
It was also noted that the clients who are now coming to the
attention of the Health Services Department have fewer personal
resources and less available in the way of a support system than
did those patients who were affected earlier. More clients are
being seen now who do not have insurance, who do not have a
strong personal support system of family. and friends and are more
likely to become a burden on Merrithew Memorial Hospital .
It was also noted that a dramatic increase is being seen in AIDS
patients who also have tuberculosis . This appears to be the case
because tuberculosis is most easily spread in close, crowded,
poorly ventilated quarters, such as homeless shelters and crack
houses . Also, because AIDS patients are more susceptible to any
disease, they are also more likely to fall prey to TB than
someone who does not have AIDS.
Our Committee would like to continue to monitor the AIDS Program
in the County over the next several months .
J
` Contra
The Board of Supervisors Costa Health Services Department
Tom Powe1st District C
rs, ouMj
NaM C.Fanden,2nd District OFFICE OF THE DIRECTOR
Robert"Schroder,3rd District
Sunne Wright MCPeak,4th District - ,�
y, Mark Flnucane,Director
Tom Todakson,5th District
Administrative Offices
o' 20 Allen Street
County Administrator Mariinez.California 94553
Phil Batchelor ,T (415)646-4416
County Administrator February 3, 1992
�,JlILra costa t.iOwmy
RECEIVED
FFR 05 1992
To: Intern Opera 'ons C mmittee r� Office of y/
eifn
From: Mark Fmucane,- it tor, Health Services Department
by Wendel Brunne , M. D., Assistant Health Services Director for
Public Health
Subject: Quarterly Report.on AIDS
AIDS CASES
As of January 20, 1992, 700 AIDS cases have been reported in our county. Of those,
68% are White, 21% are African American, and 9% are Latino. Four hundred fifty.three
(453) Contra Costa residents (65%) have been reported to have died of AIDS. Five cases of.
AIDS have been reported among children under twelve years old. Fourteen percent of cases
are now in the 20 - 29 year old age group.
The charts below demonstrate how the, AIDS cases in the county are categorized by
transmission route:
AIDS Cases in Contra Costa AIDS Cases in Contra Costa
Adult/Adolescent FLMALES Adult/Adolescent MALES
Heterosexual - 14 Injection Drug User-64 10%
Blood Products-31 (5%)
Blood Products -6
(14%)
IV Drug User-21
(49%)
Gay/Bisexual -492 (75%)
Gay/Bi/IDU -38 (6%)
Unknown/Other 2 Unknown/Other 27 (4%)
(5%)
TOTAL: 43 TOTAL: 652
,gym,Z0.1"2 JMM7 2e,IM
A-345 (11/87)
Internal Operations Committee Report February 3, 1992
AIDS in Contra Costa County Page 2
LIVING AIDS CASES
Of people living with AIDS in the county, 48% now live in Central County, 32% in
West County and 19% in East County. Twenty-eight percent of the living cases are African
American (compared to 21% of total cases). Ten percent of living cases are female
(compared to 6% of total cases). The higher percentages of living females and living
African Americans with AIDS compared to total cases demonstrate the changing demograph-
ics of the epidemic in our county.
When we compare modes of transmission and ethnic and gender representation among
people living with AIDS in each of the three regions of the county, we see important
differences. The attached charts on each region of the county show the following:
In East County, 19% of the people living with AIDS are Latino, 54% of the people
living with AIDS are gay/bisexual cases, 19% are injection drug users and their partners, and
15% of cases are among women.
In West County, 63% of people living with AIDS are African American (50 of 70
African Americans living with AIDS live in West County), 50% of the people living with
AIDS are gay/bisexual, 38% injection drug users and their partners, and 14% of cases are
women.
In Central County, 8% of people living with AIDS are African American and 8% are
Latino. Gay/bisexual men account for 75% of the people living with AIDS in Central
County and only 5% of people living with AIDS are women.
The higher numbers of females and African Americans living with AIDS is graphic
evidence that these groups are at increasing risk for AIDS.
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Internal Operations Committee Report February 3, 1992
AIDS in Contra Costa County Page 3
CITIES WITH FIVE OR MORE CASES
As the table below demonstrates, Richmond (with 149 cases) continues to be the city
in Contra Costa County with the most AIDS cases. Concord and Walnut Creek, with the
second and third most cases respectively (115 and 75), are followed by Pittsburg with 34
cases. Almost every city has had cases of AIDS.
I
CONTRA COSTA COUNTY AIDS CASES BY CITY
(Cities with five or more cases)
As of January 20, 1992 (Total=700)
City of residency
Oakley 6
Alamo ° !
Kensington
Moraga 6
Brentwood
EI Sobrante
Hercules
San Ramon 12
EI Cerrito 16 j
Pinole +6 i
Lafayette +7 ! j
Danville +6
Orinda 26
Martinez 26
Pleasant Hill 27
Antioch 30! i
San Pablo 34
Pittsburg 66
Walnut Creek 76
Concord 116
Richmond 1 14
0 20 40 60 80 100 120 140 160 180
People with AIDS (PWA)
Another eight cities had fewer
than five PWA each.
I
I
Internal Operations Committee Report February 3, 1992
AIDS in Contra Costa County Page 4
INCREASED HIV TESTING RATES FOLLOWING THE MAGIC JOHNSON STORY
During the last quarter of 1991, there was a significant increase in the number of
people testing for HIV at the Contra Costa County Alternative Test Sites. This increase
coincided with the media coverage of Magic Johnson's announcement that he was retiring
from basketball because he is HIV infected. The average number of tests per week before
the announcement was 52; following the announcement (excluding the weeks of Christmas
and New Year's Day), the average number of weekly tests was 130. This was a 250%
increase. Below is a chart of testing rates at Alternative Test Sites between July 1, 1991 and
January 19, 1992:
Number of Alternative Test Site Clients
Tested by Week During FY 1991-1992
200 People tested for HIV
150 Holidays
100
Magic Johnson announcement (Nov. 7, 1991)
50
0
2728293031323334353637383940414243444546474849505152 1 2 3
Week of the calendar year (1991 & 1992)
Weekly average before Nov.7- 52
Weekly average after Nov.7- 130 (250%/0
(excluding the weeks with the holidays)
Internal Operations Committee Report February 3, 1992
AIDS in Contra Costa County Page S
Testing for HIV also increased at STD clinics during the same time period as shown
below:
Confidential Tests Originating
in Contra .Costa County Sexually
Transmitted Disease Clinics, 1991
Confidential tests
35
Magic Johnson announcement (Nov. 7, 1991)
30 ----- - ----------- -----._ ---- ._.. -- ----- __ .
25 --
Richmond & Pittsburg STD Clinics open
20 ----- ------- — - _ .---- ---
15
0
5
0
1 6 11 16 21 26 31 36 41 46 51
.Week of the year (1 to 52)
Concord STD ® Richmond STD Pittsburg STD
It is anticipated that testing numbers will decrease after the media attention
wanes, but we continue to encourage people to test for HIV. The State Office of AIDS has
guaranteed the funds necessary to cover this increase in testing for the remainder of this
calendar year.
Internal Operations Committee Report February 3, 1992
AIDS in Contra Costa County Page 6
NEW FUNDING TO ADDRESS AIDS IN OUR COUNTY
Federal funding to address clinical and support services for people with HIV.was
passed in 1990. Through the Ryan White Comprehensive AIDS Resources Emergency
(CARE) Act, the Contra Costa HIV/AIDS Consortium last year received $131,724 in Title II
CARE Act funds.
This year, along with Alameda County, we are also eligible to receive funding under
Title I. Contra Costa expects to receive about $250,000 in Title I funding in February and
we are in the process of applying for additional funding.
At the direction of the Board last April, the Health Services Department appointed an
HIV Planning Council as required by Title I of the CARE Act. That Council is part of the
HIV/AIDS Consortium and now meets weekly to set priorities and make funding decisions
and hopes to finalize funding allocations and contracts beginning February 1.
One of the intentions of Congress in passing the CARE Act was that funding be made
available quickly to service providers. We continue to work with the Planning Council and
with Alameda County to assure timely distribution of funds.
The Planning Council has determined that initial funding from the CARE Act will
support medical social workers at Richmond and Pittsburg Health Centers (1.5 FTE) and two
positions in the AIDS Program to develop case management services. Additional priorities
set by the Council include funding for attendant care, nutritional support services (provided
by the Diablo Valley AIDS Center), buddy/companion services (provided by the Contra
Costa County AIDS Task Force), and day treatment services (provided by the AIDS Commu-
nity Network at Tranquillium) in Richmond. The Council has also provided additional
funding for the Title II-created voucher system to provide emergency housing, food and
transportation to people with HIV.
As soon as funding decisions are made by the Department of Health and Human
Services, I will report back to this committee on the decisions implemented through this
funding.
This funding is focused on care and treatment. State funds for essential disease
surveillance activities and prevention education services have been reduced in the current
fiscal year and further reductions are anticipated.
Internal Operations Committee Report February 3, 1992
AIDS in Contra Costa County Page 7
SUMMARY
The changing demographics of the AIDS epidemic in the county show an increasing
number of females and African Americans living with AIDS at this time. Changes in the
population groups affected also bring changing needs which are reflected in the current
planning for care and treatment services. Emergency food, housing, child care and transpor-
tation to vital services are all high on the list of priorities. Screening for related health
problems such as Tuberculosis is becoming clearly necessary as the populations are dually
affected.
Funding changes require new planning and coordination efforts, and community
participation in this process has produced increased collaboration and some truly innovative
program developments. The Health Services Department must also put effort into increased
resource development efforts as State funds for vital services in disease monitoring and
prevention education are cut.
Integration of programs between public and private non-profit agencies is being
emphasized, as is the integration of AIDS with departmental programs such as other commu-
nicable disease (including Tb and sexually transmitted disease), maternal and child health and
the programs of the Hospital & Clinics Division.
THE AIDS EPIDEMIC IN
CONTRA COSTA COUNTY
DECEMBER 1991
ESTIMATES AND PROJECTIONS
Epidemiology and Surveillance Unit
AIDS Program * Public Health Division
Contra Costa County health Services Department
597 Center Avenue, Suite 200
Martinez, California, 94553
(510) 313-6770
Since 1982, 700 Contra Costa
County. residents have been
diagnosed with AIDS (PWAs) and
reported to the Public Health .
Department.'
We estimate that a total of 3 ,500
county residents are infected with
HIV-10
Approximately 60% of all PWAs
in the county have- 'died already.
Approximately 280 county PWAs
are alive at the present time.
A more inclusive AIDS case
definition will be ' used in 1992,
We expect the total number of
new AIDS diagnoses in 1992 to be
approximately 7500
People With AIDS (PWA) in
Contra Costa County, CA. 1982-1994
Reported and Projected Cases.
1000
800 .......----------.............. ....... 750-- ............ -
600 ..
...................................... .
............
.................................
400 ............ ........ .... ... ....... ......
...99.......128...._._ 50195 200,
................. ..........................................................
200 .. .
40 S3 71.
7
1 171
7 6 15
0
1982 1983 1984 1985 1986 1987 1988 1989 1990 19911992 1993 1994
M Reported Expected 'New Definition"
Projected by 12/1991= 750
Projected by 1211992- 1,500
Projected by 12/1994- 2,000
After 1992, we expect , yearly
AIDS diagnoses to dropback to
approximately 200,
Approximately 2,000 Contra
Costa County residents will
have been diagnosed with AIDS
by the end of 1994.
It seems reasonable to expect
that at least 1 ,000 (50%) will
be alive at that time,
Not It is not clear how many
new infections may occur each
year.